Provider Demographics
NPI:1669079455
Name:WHITE, REBECCA CYNTHIA (PT, DPT)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:CYNTHIA
Last Name:WHITE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 REISTERSTOWN RD STE 125
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-2978
Mailing Address - Country:US
Mailing Address - Phone:410-484-0081
Mailing Address - Fax:
Practice Address - Street 1:1700 REISTERSTOWN RD STE 125
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-2978
Practice Address - Country:US
Practice Address - Phone:410-484-0081
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-05
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD28002225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist