Provider Demographics
NPI:1871192294
Name:DICKINSON, REBECCA HELEN (MOT, OTR/L)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:HELEN
Last Name:DICKINSON
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1180 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:JEANNETTE
Mailing Address - State:PA
Mailing Address - Zip Code:15644-6603
Mailing Address - Country:US
Mailing Address - Phone:724-757-8339
Mailing Address - Fax:
Practice Address - Street 1:1180 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:JEANNETTE
Practice Address - State:PA
Practice Address - Zip Code:15644-6603
Practice Address - Country:US
Practice Address - Phone:724-757-8339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-19
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAOC016847OtherOCCUPATIONAL THERAPIST LICENSURE PENNSYLVANIA
FLOT20519OtherFLORIDA BOARD OF OCCUPATIONAL THERAPY LICENSURE