Provider Demographics
NPI:1568994317
Name:PICKERING, REBECCA
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:PICKERING
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 1:15 MIDDLE RD
Mailing Address - Street 2:
Mailing Address - City:MERRIMAC
Mailing Address - State:MA
Mailing Address - Zip Code:01860-2413
Mailing Address - Country:US
Mailing Address - Phone:508-527-5846
Mailing Address - Fax:
Practice Address - Street 1:15 MIDDLE RD
Practice Address - Street 2:
Practice Address - City:MERRIMAC
Practice Address - State:MA
Practice Address - Zip Code:01860-2413
Practice Address - Country:US
Practice Address - Phone:508-527-5846
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-31
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer