Provider Demographics
NPI:1003148834
Name:THOMAS, REBECCA (MSOTR/L)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MSOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:859 LANDY HILL RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:KY
Mailing Address - Zip Code:40006-8642
Mailing Address - Country:US
Mailing Address - Phone:502-663-3588
Mailing Address - Fax:
Practice Address - Street 1:859 LANDY HILL RD
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:KY
Practice Address - Zip Code:40006-8642
Practice Address - Country:US
Practice Address - Phone:502-663-3588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-04
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYT4265225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist