Healthcare Provider Details

I. General information

NPI: 1710920145
Provider Name (Legal Business Name): REBECCA A GEORGE OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1004 LEAWOOD DR
FRANKFORT KY
40601-3349
US

IV. Provider business mailing address

1004 LEAWOOD DR
FRANKFORT KY
40601-3349
US

V. Phone/Fax

Practice location:
  • Phone: 502-223-7403
  • Fax: 502-223-5016
Mailing address:
  • Phone: 502-223-7403
  • Fax: 502-223-5016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberR0629
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: