Provider Demographics
NPI:1578829818
Name:FERRARESE, REBECCA (DPT)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:FERRARESE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:SCHNACK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:8240 W. CACTUS RD.
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381
Mailing Address - Country:US
Mailing Address - Phone:623-878-9696
Mailing Address - Fax:623-776-0668
Practice Address - Street 1:8240 W. CACTUS ROAD.
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381
Practice Address - Country:US
Practice Address - Phone:623-878-9696
Practice Address - Fax:623-776-0668
Is Sole Proprietor?:No
Enumeration Date:2012-04-10
Last Update Date:2018-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38586225100000X
AZ113532251X0800X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist