MEDICARE: REBEKAH LYNN GLADDEN OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	OT011363	OH

General Provider Information

NPI Number	:	1851983027
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBEKAH LYNN GLADDEN OTR/L

Provider Business Mailing Address
First Line	:	243 BALSAM CT
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45246-2403
Country	:	US
Telephone Number	:	865-223-9029
Fax Number	:

Provider Business Practice Location Address
First Line	:	206 ALBERT SABIN WAY
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45267-2800
Country	:	US
Telephone Number	:	513-221-0325
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/09/2021
Last Update Date	:	02/09/2021

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