Provider Demographics
NPI:1760189179
Name:PLUMB, REBECCA ANN POSTOLL (OTR/L)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:ANN POSTOLL
Last Name:PLUMB
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:ANN
Other - Last Name:POSTOLL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:7 COLONIAL CLUB DR SE
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30102-6715
Mailing Address - Country:US
Mailing Address - Phone:404-668-8545
Mailing Address - Fax:
Practice Address - Street 1:7 COLONIAL CLUB DR SE
Practice Address - Street 2:
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30102-6715
Practice Address - Country:US
Practice Address - Phone:404-668-8545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-15
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7434225X00000X
FLOT24460225X00000X
TX124354225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN7434OtherSTATE OF TN DEPARTMENT OF HEALTH BOARD OF OCCUPATIONAL THERAPY