Provider Demographics
NPI:1083896609
Name:MCAFEE, REBECCA SUE (COTAL)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:SUE
Last Name:MCAFEE
Suffix:
Gender:F
Credentials:COTAL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 910
Mailing Address - Street 2:GREENE VALLEY DEVELOPMENTAL CENTER
Mailing Address - City:GREENEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37744-0910
Mailing Address - Country:US
Mailing Address - Phone:423-787-6800
Mailing Address - Fax:423-787-6574
Practice Address - Street 1:4850 EAST ANDREW JOHNSON HIGHWAY
Practice Address - Street 2:GREENE VALLEY DEVELOPMENTAL CENTER
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37744-0910
Practice Address - Country:US
Practice Address - Phone:423-787-6800
Practice Address - Fax:423-787-6574
Is Sole Proprietor?:No
Enumeration Date:2007-12-05
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNOTA103224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant