Provider Demographics
NPI:1598210650
Name:WEST, REBEKAH
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:
Last Name:WEST
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:PAWCATUCK
Mailing Address - State:CT
Mailing Address - Zip Code:06379-1805
Mailing Address - Country:US
Mailing Address - Phone:860-608-4948
Mailing Address - Fax:
Practice Address - Street 1:110 AIRPORT RD
Practice Address - Street 2:SUITE 102
Practice Address - City:WESTERLY
Practice Address - State:RI
Practice Address - Zip Code:02891-3434
Practice Address - Country:US
Practice Address - Phone:401-348-9400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-18
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIOT00966225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics