Provider Demographics
NPI:1598739237
Name:WHITT, REBECCA S (ATC, AT)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:S
Last Name:WHITT
Suffix:
Gender:F
Credentials:ATC, AT
Other - Prefix:MISS
Other - First Name:REBECCA
Other - Middle Name:S
Other - Last Name:DANIELS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC, AT
Mailing Address - Street 1:330 ABBOTSBURY DR
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-9120
Mailing Address - Country:US
Mailing Address - Phone:614-323-6541
Mailing Address - Fax:
Practice Address - Street 1:330 ABBOTSBURY DR
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-9120
Practice Address - Country:US
Practice Address - Phone:614-323-6541
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-16
Last Update Date:2015-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT0016152255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer