Provider Demographics
NPI:1346445525
Name:DEAN, REBECCA (OTR)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:DEAN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:776 LYNMAR WAY
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-7129
Mailing Address - Country:US
Mailing Address - Phone:908-354-3932
Mailing Address - Fax:908-354-3932
Practice Address - Street 1:776 LYNMAR WAY
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-7129
Practice Address - Country:US
Practice Address - Phone:908-354-3932
Practice Address - Fax:908-354-3932
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJOTR46TR00297500225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist