Provider Demographics
NPI:1417706052
Name:HAHN, REBECCA (OTD)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:HAHN
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:LANDIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:404 GREENBRIER AVE
Mailing Address - Street 2:
Mailing Address - City:WHITE SULPHUR SPRINGS
Mailing Address - State:WV
Mailing Address - Zip Code:24986-2008
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:345 POCAHONTAS TRL
Practice Address - Street 2:
Practice Address - City:WHITE SULPHUR SPRINGS
Practice Address - State:WV
Practice Address - Zip Code:24986-9793
Practice Address - Country:US
Practice Address - Phone:304-536-4661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-15
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2419225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist