Provider Demographics
NPI:1861698433
Name:KLEIMAN, REBECCA WING (MS,CCC-SLP, BCBA)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:WING
Last Name:KLEIMAN
Suffix:
Gender:F
Credentials:MS,CCC-SLP, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:627 SPRING OAKS BLVD
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-7311
Mailing Address - Country:US
Mailing Address - Phone:407-280-3128
Mailing Address - Fax:
Practice Address - Street 1:627 SPRING OAKS BLVD
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-7311
Practice Address - Country:US
Practice Address - Phone:407-280-3128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-21
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 7214235Z00000X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL014278700Medicaid