Provider Demographics
NPI:1265227078
Name:MORALES, REBECCA (REBECCA MORALES, OTA)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:MORALES
Suffix:
Gender:
Credentials:REBECCA MORALES, OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16400 BLANCO RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-1902
Mailing Address - Country:US
Mailing Address - Phone:210-572-4954
Mailing Address - Fax:
Practice Address - Street 1:16400 BLANCO RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-1902
Practice Address - Country:US
Practice Address - Phone:210-572-4954
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-11
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX215564224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Single Specialty