Provider Demographics
NPI:1518474279
Name:VAARA, REBECCA MEGAN (MOTR/L)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:MEGAN
Last Name:VAARA
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:908 MANITOU LN
Mailing Address - Street 2:
Mailing Address - City:LUDINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:49431-2734
Mailing Address - Country:US
Mailing Address - Phone:231-690-5220
Mailing Address - Fax:
Practice Address - Street 1:908 MANITOU LN
Practice Address - Street 2:
Practice Address - City:LUDINGTON
Practice Address - State:MI
Practice Address - Zip Code:49431-2734
Practice Address - Country:US
Practice Address - Phone:231-690-5220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-03
Last Update Date:2018-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201004322225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist