Provider Demographics
NPI:1457606469
Name:GILMORE, REBEKAH KAY (MOT, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:REBEKAH
Middle Name:KAY
Last Name:GILMORE
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 1:122 N STAR CT
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-7830
Mailing Address - Country:US
Mailing Address - Phone:817-800-4431
Mailing Address - Fax:
Practice Address - Street 1:815 PECAN ST
Practice Address - Street 2:
Practice Address - City:BANDERA
Practice Address - State:TX
Practice Address - Zip Code:78003-2026
Practice Address - Country:US
Practice Address - Phone:830-460-3892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-16
Last Update Date:2022-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1776225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist