Provider Demographics
NPI:1689903791
Name:ANDREWS, REBECCA DELLA (MOT)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:DELLA
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:MOT
Other - Prefix:MISS
Other - First Name:REBECCA
Other - Middle Name:DELLA
Other - Last Name:MANSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MOT
Mailing Address - Street 1:15640 N 7TH ST
Mailing Address - Street 2:STE 6
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-3512
Mailing Address - Country:US
Mailing Address - Phone:602-439-3800
Mailing Address - Fax:602-439-3802
Practice Address - Street 1:15640 N 7TH ST
Practice Address - Street 2:STE 6
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85022-3512
Practice Address - Country:US
Practice Address - Phone:602-439-3800
Practice Address - Fax:602-439-3802
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-18
Last Update Date:2009-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4296225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist