Provider Demographics
NPI:1750675583
Name:MITCHELL, REBECCA CORINNE (DPT)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:CORINNE
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:267 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01040-6513
Mailing Address - Country:US
Mailing Address - Phone:413-420-2850
Mailing Address - Fax:413-532-4954
Practice Address - Street 1:267 HIGH ST
Practice Address - Street 2:
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-6513
Practice Address - Country:US
Practice Address - Phone:413-420-2850
Practice Address - Fax:413-532-4954
Is Sole Proprietor?:No
Enumeration Date:2011-06-09
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA17460225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist