Rebecca Angela Therese Manley, MA CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

10483 Issued in MN

Practice address

940 Penamint CT
Chanhassen, MN 55317-9598

Phone

(218) 348-9169

NPI assigned

Oct 27, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Fraser

  • Rehabilitation Clinic/Center
  • Richfield, MN
  • NPI 1063568574
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1603756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1245830645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 PENAMINT CT",
            "city": "CHANHASSEN",
            "state": "MN",
            "postal_code": "553179598",
            "telephone_number": "218-348-9169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 PENAMINT CT",
            "city": "CHANHASSEN",
            "state": "MN",
            "postal_code": "553179598",
            "telephone_number": "218-348-9169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANLEY",
        "first_name": "REBECCA",
        "middle_name": "ANGELA THERESE",
        "credential": "MA CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-27",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "10483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lucas Myeong-Kil Lund
• Luxealign PLLC
• Luxottica of America Inc.
• Jill Renee Magnuson, MA, LP
• Carolyn C Majkrzak, PA-C
• Leigh Marasco, PT
• Katie Anne Mark, MSW, LICSW
• Douglas Martin
• Lindsay Jo McCain
• Ian Patrick McCann, D.C.

• Speech-Language Pathologist in Chanhassen, MN
• Providers in Chanhassen, MN by specialty
• Speech-Language Pathologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.