Provider Demographics
NPI:1699009639
Name:LEONARD, REBECCA (PT, MS, DPT, PCS)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:LEONARD
Suffix:
Gender:F
Credentials:PT, MS, DPT, PCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6208 MONTROSE ROAD
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852
Mailing Address - Country:US
Mailing Address - Phone:301-468-9343
Mailing Address - Fax:301-230-2127
Practice Address - Street 1:3204 TOWER OAKS BLVD STE 150
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-4211
Practice Address - Country:US
Practice Address - Phone:301-468-9343
Practice Address - Fax:301-230-2127
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-23
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15297225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist