Provider Demographics
NPI:1992843775
Name:MAUL, REBECCA ANN (PTA)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:ANN
Last Name:MAUL
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:20455 LENNON ST
Mailing Address - Street 2:
Mailing Address - City:HARPER WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48225-1473
Mailing Address - Country:US
Mailing Address - Phone:313-882-7934
Mailing Address - Fax:
Practice Address - Street 1:7733 E JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48214-3707
Practice Address - Country:US
Practice Address - Phone:313-499-4260
Practice Address - Fax:313-499-4878
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant