Provider Demographics
NPI:1821454828
Name:WILLSON, REBECCA MARKES (MOT)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:MARKES
Last Name:WILLSON
Suffix:
Gender:F
Credentials:MOT
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:JEAN
Other - Last Name:MARKES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6010 W AMARILLO BLVD
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-1990
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6010 W AMARILLO BLVD
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-1990
Practice Address - Country:US
Practice Address - Phone:806-355-9703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-06
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist