Provider Demographics
NPI:1437572013
Name:MILBURN, REBECCA (MA, L/CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:
Last Name:MILBURN
Suffix:
Gender:F
Credentials:MA, L/CCC-SLP
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:DELONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9700 SW PINE RD
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:KS
Mailing Address - Zip Code:67002-8375
Mailing Address - Country:US
Mailing Address - Phone:316-558-1058
Mailing Address - Fax:
Practice Address - Street 1:9700 SW PINE RD
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:KS
Practice Address - Zip Code:67002-8375
Practice Address - Country:US
Practice Address - Phone:316-558-1058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-02
Last Update Date:2024-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2461235Z00000X
KS01190101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist