Provider Demographics
NPI:1578035150
Name:BROWN, REBECCA JOY (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:JOY
Last Name:BROWN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14684 WESTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:NOVELTY
Mailing Address - State:OH
Mailing Address - Zip Code:44072-9629
Mailing Address - Country:US
Mailing Address - Phone:216-904-6054
Mailing Address - Fax:
Practice Address - Street 1:845 MADISON AVE
Practice Address - Street 2:
Practice Address - City:PAINESVILLE
Practice Address - State:OH
Practice Address - Zip Code:44077-5413
Practice Address - Country:US
Practice Address - Phone:216-904-6054
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-20
Last Update Date:2018-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT008618225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist