Provider Demographics
NPI:1497889943
Name:WOLONGEVICZ, REBECCA (MS, OTR/L, CHT)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:WOLONGEVICZ
Suffix:
Gender:F
Credentials:MS, OTR/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 NORTH ST
Mailing Address - Street 2:LOWER LEVEL
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-3825
Mailing Address - Country:US
Mailing Address - Phone:508-771-6685
Mailing Address - Fax:508-771-6687
Practice Address - Street 1:130 NORTH ST
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-3825
Practice Address - Country:US
Practice Address - Phone:508-771-6685
Practice Address - Fax:508-771-6687
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2017-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8962225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand