Provider Demographics
NPI:1598098790
Name:CAMPBELL, REBECCA (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:
Last Name:CAMPBELL
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 1:2128 SUMAC DR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29505-3804
Mailing Address - Country:US
Mailing Address - Phone:843-616-3597
Mailing Address - Fax:843-393-4780
Practice Address - Street 1:1482 POCKET RD
Practice Address - Street 2:
Practice Address - City:DARLINGTON
Practice Address - State:SC
Practice Address - Zip Code:29532-8416
Practice Address - Country:US
Practice Address - Phone:843-616-3597
Practice Address - Fax:843-393-4780
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-08
Last Update Date:2009-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3322225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist