Provider Demographics
NPI:1912120445
Name:WATSON, REBEKAH M (OTR/L)
Entity Type:Individual
Prefix:MISS
First Name:REBEKAH
Middle Name:M
Last Name:WATSON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8338 W 13TH STREET N
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67212-2984
Mailing Address - Country:US
Mailing Address - Phone:316-210-3578
Mailing Address - Fax:
Practice Address - Street 1:8338 W 13TH STREET N
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67212-2984
Practice Address - Country:US
Practice Address - Phone:316-210-3578
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17-02163225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist