Provider Demographics
NPI:1740918168
Name:SCHMIDT, REBECCA BERNADETTE (COTA/L)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:BERNADETTE
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:BERNADETTE
Other - Last Name:TRAUTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:396 W CENTER ST
Mailing Address - Street 2:
Mailing Address - City:ELYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17824-7111
Mailing Address - Country:US
Mailing Address - Phone:570-692-1070
Mailing Address - Fax:
Practice Address - Street 1:150 CHAMBERLAINE AVE
Practice Address - Street 2:
Practice Address - City:POTTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17901-8648
Practice Address - Country:US
Practice Address - Phone:570-593-5484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-12
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP010152224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant