Provider Demographics
NPI:1841384484
Name:SHMUKLER, REBECCA ELLEN (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:ELLEN
Last Name:SHMUKLER
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 1:7704 MAPLERIDGE DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024
Mailing Address - Country:US
Mailing Address - Phone:214-566-2687
Mailing Address - Fax:866-323-1955
Practice Address - Street 1:7704 MAPLERIDGE DR
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024
Practice Address - Country:US
Practice Address - Phone:214-566-2687
Practice Address - Fax:866-323-1955
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX110405225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8T1310OtherBLUECROSS BLUESHIELD
TX00545VMedicare ID - Type Unspecified