Healthcare Provider Details

I. General information

NPI: 1457837924
Provider Name (Legal Business Name): REBECCA LOONEY OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2018
Last Update Date: 07/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 HEATHER RD
DRACUT MA
01826-4157
US

IV. Provider business mailing address

101 HEATHER RD
DRACUT MA
01826-4157
US

V. Phone/Fax

Practice location:
  • Phone: 978-618-1517
  • Fax: 855-232-8604
Mailing address:
  • Phone: 978-618-1517
  • Fax: 855-232-8604

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number9574
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: