Provider Demographics
NPI:1467002683
Name:GILMORE, REBECCA I (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:I
Last Name:GILMORE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 CASTLE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:ASPEN
Mailing Address - State:CO
Mailing Address - Zip Code:81611-1159
Mailing Address - Country:US
Mailing Address - Phone:970-925-1120
Mailing Address - Fax:
Practice Address - Street 1:100 S JACKSON AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15202-3428
Practice Address - Country:US
Practice Address - Phone:412-734-6030
Practice Address - Fax:412-734-6881
Is Sole Proprietor?:No
Enumeration Date:2019-09-19
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO225X00000X
PAOC007776225XP0019X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation