Provider Demographics
NPI:1730484437
Name:SOTTILE, REBECCA LYNNE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:LYNNE
Last Name:SOTTILE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10114 SPINNING WHEEL CT
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22032-1629
Mailing Address - Country:US
Mailing Address - Phone:703-402-3828
Mailing Address - Fax:703-978-1152
Practice Address - Street 1:10114 SPINNING WHEEL CT
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22032-1629
Practice Address - Country:US
Practice Address - Phone:703-402-3828
Practice Address - Fax:703-978-1152
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-11
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119003791225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist