Provider Demographics
NPI:1649580788
Name:CORWIN, REBECCA A (COTA/L)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:A
Last Name:CORWIN
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:A
Other - Last Name:CRONN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA/L
Mailing Address - Street 1:2503 N MONROE ST
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67502-3463
Mailing Address - Country:US
Mailing Address - Phone:785-769-6046
Mailing Address - Fax:
Practice Address - Street 1:810 E 30TH AVE
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67502-4340
Practice Address - Country:US
Practice Address - Phone:620-669-8662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-07
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1800720224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant