Provider Demographics
NPI:1508156134
Name:WATKINS, REBEKAH JEAN
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:JEAN
Last Name:WATKINS
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 1:196 TURNPIKE RD
Mailing Address - Street 2:
Mailing Address - City:EAGLE BRIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:12057-2423
Mailing Address - Country:US
Mailing Address - Phone:518-681-2946
Mailing Address - Fax:
Practice Address - Street 1:532 MAIN ST
Practice Address - Street 2:
Practice Address - City:BENNINGTON
Practice Address - State:VT
Practice Address - Zip Code:05201-2875
Practice Address - Country:US
Practice Address - Phone:802-447-2900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-16
Last Update Date:2011-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist