Provider Demographics
NPI:1578285615
Name:MCDANIEL, REBEKAH (MOT)
Entity Type:Individual
Prefix:MRS
First Name:REBEKAH
Middle Name:
Last Name:MCDANIEL
Suffix:
Gender:F
Credentials:MOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 MORNING CREEK DR
Mailing Address - Street 2:
Mailing Address - City:EASLEY
Mailing Address - State:SC
Mailing Address - Zip Code:29640-2571
Mailing Address - Country:US
Mailing Address - Phone:864-201-2863
Mailing Address - Fax:
Practice Address - Street 1:105 WILLOW PL
Practice Address - Street 2:
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29640-1385
Practice Address - Country:US
Practice Address - Phone:864-855-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-15
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6633225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist