Provider Demographics
NPI:1194283804
Name:ADAMS, REBEKAH M (CPED)
Entity type:Individual
Prefix:
First Name:REBEKAH
Middle Name:M
Last Name:ADAMS
Suffix:
Gender:F
Credentials:CPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2905 BOB WALLACE AVE SW STE B
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35805-4166
Mailing Address - Country:US
Mailing Address - Phone:256-203-2647
Mailing Address - Fax:256-964-8134
Practice Address - Street 1:2905 BOB WALLACE AVE SW STE B
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35805-4166
Practice Address - Country:US
Practice Address - Phone:256-203-2647
Practice Address - Fax:256-964-8134
Is Sole Proprietor?:No
Enumeration Date:2019-03-12
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL559224L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224L00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPedorthist