Healthcare Provider Details

I. General information

NPI: 1881279875
Provider Name (Legal Business Name): REBECKA OCKAY CPM, LM, LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/11/2021
Last Update Date: 12/21/2024
Certification Date: 12/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1303 BRAGG RD
FREDERICKSBURG VA
22407-4915
US

IV. Provider business mailing address

1303 BRAGG RD
FREDERICKSBURG VA
22407-4915
US

V. Phone/Fax

Practice location:
  • Phone: 501-593-9675
  • Fax:
Mailing address:
  • Phone: 501-593-9675
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number0129000200
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number0019019817
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: