Provider Demographics
NPI:1225360100
Name:THOMASSON, REBECCA M (ROT/L)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:M
Last Name:THOMASSON
Suffix:
Gender:F
Credentials:ROT/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1273 REMOUNT RD
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-3439
Mailing Address - Country:US
Mailing Address - Phone:843-747-2787
Mailing Address - Fax:843-747-0001
Practice Address - Street 1:1273 REMOUNT RD
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-3439
Practice Address - Country:US
Practice Address - Phone:843-747-2787
Practice Address - Fax:843-747-0001
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-03
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3171225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist