Provider Demographics
NPI:1588281794
Name:WHITENER, REBEKAH (MS, OTR/L)
Entity type:Individual
Prefix:
First Name:REBEKAH
Middle Name:
Last Name:WHITENER
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:163 SUMMER ST APT 33
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02143-2627
Mailing Address - Country:US
Mailing Address - Phone:972-523-9747
Mailing Address - Fax:
Practice Address - Street 1:163 SUMMER ST APT 33
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02143-2627
Practice Address - Country:US
Practice Address - Phone:972-523-9747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-03
Last Update Date:2020-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA13211225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist