Provider Demographics
NPI:1306307699
Name:SCHACHNER, REBEKAH JORDAN (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:REBEKAH
Middle Name:JORDAN
Last Name:SCHACHNER
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 GLEN IRIS DR NE UNIT 3320
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-2982
Mailing Address - Country:US
Mailing Address - Phone:954-649-7427
Mailing Address - Fax:
Practice Address - Street 1:5660 LAKE FORREST DR
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-4635
Practice Address - Country:US
Practice Address - Phone:404-500-9185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-28
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-19-82343106S00000X
GAOT008829225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician