Provider Demographics
NPI:1487907663
Name:BUCCI, REBECCA COLE (MS, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:COLE
Last Name:BUCCI
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5720 OAK MILL CT
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23059-6986
Mailing Address - Country:US
Mailing Address - Phone:804-364-4366
Mailing Address - Fax:
Practice Address - Street 1:5720 OAK MILL CT
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23059-6986
Practice Address - Country:US
Practice Address - Phone:804-364-4366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-24
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202003181235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist