Provider Demographics
NPI:1831219427
Name:GLASER, REBECCA LINN (OTR)
Entity type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:LINN
Last Name:GLASER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1225 COUNTY ROAD 2937
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:TX
Mailing Address - Zip Code:76234-7422
Mailing Address - Country:US
Mailing Address - Phone:940-367-9515
Mailing Address - Fax:940-479-2607
Practice Address - Street 1:9204 T N SKILES RD
Practice Address - Street 2:
Practice Address - City:PONDER
Practice Address - State:TX
Practice Address - Zip Code:76259-5819
Practice Address - Country:US
Practice Address - Phone:940-479-2612
Practice Address - Fax:940-479-2607
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX107313225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist