Provider Demographics
NPI:1518198167
Name:BEVIN, REBEKAH SOMMERS (OTR/L)
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:SOMMERS
Last Name:BEVIN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:REBEKAH
Other - Middle Name:SOMMERS
Other - Last Name:WILCOX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:10 BENNING ST # 171
Mailing Address - Street 2:
Mailing Address - City:WEST LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03784-3402
Mailing Address - Country:US
Mailing Address - Phone:207-318-6946
Mailing Address - Fax:
Practice Address - Street 1:24 OLD ETNA RD
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03766-1937
Practice Address - Country:US
Practice Address - Phone:603-448-2234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-30
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT2173225X00000X
NH2268225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist