Provider Demographics
NPI:1467913129
Name:REHNCY, STEVI A
Entity Type:Individual
Prefix:
First Name:STEVI
Middle Name:A
Last Name:REHNCY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 CENTRE ST STE 6&7
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:CT
Mailing Address - Zip Code:06420-3844
Mailing Address - Country:US
Mailing Address - Phone:617-501-0283
Mailing Address - Fax:
Practice Address - Street 1:6 JOSAN DR
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:CT
Practice Address - Zip Code:06385-1108
Practice Address - Country:US
Practice Address - Phone:617-501-0283
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-26
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4749225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004221868-02Medicaid