Provider Demographics
NPI:1588815112
Name:NEILSON, RABYN R (OT)
Entity Type:Individual
Prefix:
First Name:RABYN
Middle Name:R
Last Name:NEILSON
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 CROWDER RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:NC
Mailing Address - Zip Code:27025-7662
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:260 CROWDER RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:NC
Practice Address - Zip Code:27025-7662
Practice Address - Country:US
Practice Address - Phone:803-389-0962
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-01
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6981225X00000X
SC3670225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist