Provider Demographics
NPI:1801247564
Name:CHASTAIN, REBEKAH KATE (OTR/L)
Entity type:Individual
Prefix:
First Name:REBEKAH
Middle Name:KATE
Last Name:CHASTAIN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:REBEKAH
Other - Middle Name:KATE
Other - Last Name:HILLMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:303 MERMAN RD
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37663-3450
Mailing Address - Country:US
Mailing Address - Phone:423-502-7678
Mailing Address - Fax:
Practice Address - Street 1:303 MERMAN RD
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37663-3450
Practice Address - Country:US
Practice Address - Phone:423-502-7678
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-23
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4898225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist