Provider Demographics
NPI:1144732447
Name:PUGH, REBECCA RUTH
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:RUTH
Last Name:PUGH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15820 ADDISON RD
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-3549
Mailing Address - Country:US
Mailing Address - Phone:866-919-3240
Mailing Address - Fax:
Practice Address - Street 1:401 N SHANNON ST
Practice Address - Street 2:
Practice Address - City:KAUFMAN
Practice Address - State:TX
Practice Address - Zip Code:75142-1013
Practice Address - Country:US
Practice Address - Phone:214-212-2380
Practice Address - Fax:214-212-2380
Is Sole Proprietor?:No
Enumeration Date:2017-10-27
Last Update Date:2017-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX331492355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant