Provider Demographics
NPI:1033993415
Name:PILET, REBECCA LEA (MOT, OTR/L)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:LEA
Last Name:PILET
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:LEA
Other - Last Name:PRIGGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2101 WOODDALE DR
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-4441
Mailing Address - Country:US
Mailing Address - Phone:651-738-9888
Mailing Address - Fax:
Practice Address - Street 1:5891 RICE CREEK PKWY UNIT 132
Practice Address - Street 2:
Practice Address - City:SHOREVIEW
Practice Address - State:MN
Practice Address - Zip Code:55126-4408
Practice Address - Country:US
Practice Address - Phone:651-366-9314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-24
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN107273225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist