Provider Demographics
NPI:1619211026
Name:TROGDEN, REBECCA GAY (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:GAY
Last Name:TROGDEN
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8005 US HIGHWAY 60 W
Mailing Address - Street 2:
Mailing Address - City:LEWISPORT
Mailing Address - State:KY
Mailing Address - Zip Code:42351-7079
Mailing Address - Country:US
Mailing Address - Phone:270-295-6756
Mailing Address - Fax:270-295-3759
Practice Address - Street 1:8005 US HIGHWAY 60 W
Practice Address - Street 2:
Practice Address - City:LEWISPORT
Practice Address - State:KY
Practice Address - Zip Code:42351-7079
Practice Address - Country:US
Practice Address - Phone:270-295-6756
Practice Address - Fax:270-295-3759
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-26
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYA2679224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant