Provider Demographics
NPI:1568619377
Name:THOMPSON, REBECCA T (OT)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:T
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:S
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:P O BOX 911148
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40591-1148
Mailing Address - Country:US
Mailing Address - Phone:859-278-2121
Mailing Address - Fax:859-276-1649
Practice Address - Street 1:467 EASTERN BY-PASS
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-2325
Practice Address - Country:US
Practice Address - Phone:859-623-6334
Practice Address - Fax:859-623-6336
Is Sole Proprietor?:No
Enumeration Date:2008-08-22
Last Update Date:2008-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR3548225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist