Provider Demographics
NPI:1639390222
Name:METHENY, REBECCA NOHE (COTA)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:NOHE
Last Name:METHENY
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2085 CAVEN FORK
Mailing Address - Street 2:
Mailing Address - City:MURRAYSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26164
Mailing Address - Country:US
Mailing Address - Phone:304-389-1243
Mailing Address - Fax:
Practice Address - Street 1:200 ELIZABETH ST
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25311
Practice Address - Country:US
Practice Address - Phone:304-348-7740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVC1128224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant