=====================================================
General NPI Number Information
=====================================================
NPI Number | 1023170339
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | REBECCA SHERWOOD BORDEAUX OTR
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/14/2006
-----------------------------------------------------
Last Update Date | 02/05/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9 W SUMMIT AVE
-----------------------------------------------------
City | ASHEVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28803-0047
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 877-596-8056
-----------------------------------------------------
Fax | 828-596-8056
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 91 CISCO RD
-----------------------------------------------------
City | ASHEVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28805-1335
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-298-3443
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225XP0200X
-----------------------------------------------------
Taxonomy Name | Pediatric Occupational Therapist
-----------------------------------------------------
License Number | 771
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------