Provider Demographics
NPI:1447789672
Name:RAY, REBECCA LYNN (COTA)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:LYNN
Last Name:RAY
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:LYNN
Other - Last Name:HUGHES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:81 HUGHES LN
Mailing Address - Street 2:
Mailing Address - City:TUNNEL HILL
Mailing Address - State:GA
Mailing Address - Zip Code:30755-8205
Mailing Address - Country:US
Mailing Address - Phone:423-580-4173
Mailing Address - Fax:
Practice Address - Street 1:81 HUGHES LN
Practice Address - Street 2:
Practice Address - City:TUNNEL HILL
Practice Address - State:GA
Practice Address - Zip Code:30755-8205
Practice Address - Country:US
Practice Address - Phone:423-580-4173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2106224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant