Provider Demographics
NPI:1194136069
Name:KNOWLES, REBECCA (OTR/L)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:KNOWLES
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 1:195 RUSSELL ST
Mailing Address - Street 2:SUITE B-13
Mailing Address - City:HADLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01035-9515
Mailing Address - Country:US
Mailing Address - Phone:413-230-6600
Mailing Address - Fax:
Practice Address - Street 1:195 RUSSELL ST
Practice Address - Street 2:SUITE B-13
Practice Address - City:HADLEY
Practice Address - State:MA
Practice Address - Zip Code:01035-9515
Practice Address - Country:US
Practice Address - Phone:413-230-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-14
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT072.0103235225X00000X
MA11204225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist