Provider Demographics
NPI:1114274347
Name:NEHRT, REBECCA (MOT, OTR/L)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:NEHRT
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:946 IVY CT
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:IL
Mailing Address - Zip Code:62294-3141
Mailing Address - Country:US
Mailing Address - Phone:314-821-7554
Mailing Address - Fax:314-821-0048
Practice Address - Street 1:1001 S KIRKWOOD RD
Practice Address - Street 2:STE 150
Practice Address - City:KIRKWOOD
Practice Address - State:MO
Practice Address - Zip Code:63122-7254
Practice Address - Country:US
Practice Address - Phone:314-821-7554
Practice Address - Fax:314-821-0048
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-07
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012018026225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist