Healthcare Provider Details

I. General information

NPI: 1306307699
Provider Name (Legal Business Name): REBEKAH JORDAN SCHACHNER OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2019
Last Update Date: 09/17/2024
Certification Date: 09/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5660 LAKE FORREST DR
ATLANTA GA
30342-4635
US

IV. Provider business mailing address

525 GLEN IRIS DR NE UNIT 3320
ATLANTA GA
30308-2982
US

V. Phone/Fax

Practice location:
  • Phone: 404-500-9185
  • Fax:
Mailing address:
  • Phone: 954-649-7427
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT008829
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-19-82343
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: