Healthcare Provider Details

I. General information

NPI: 1548350390
Provider Name (Legal Business Name): REBECCA MARIE HALL OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 W 64TH ST
RICHFIELD MN
55423-1001
US

IV. Provider business mailing address

1110 KERBER PASS
CHASKA MN
55318-5402
US

V. Phone/Fax

Practice location:
  • Phone: 612-798-8341
  • Fax:
Mailing address:
  • Phone: 952-215-9777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number102777
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number102777
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: