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General NPI Number Information
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NPI Number | 1366030827
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Entity Type | Individual
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Provider Name | REBEKAH MCILVOY MS, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 01/08/2021
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Last Update Date | 03/24/2021
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Provider Practice Location Address
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Address Line | 6015 TIMBER RIDGE DR
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City | PROSPECT
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State | KY
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Zip | 40059-8134
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Country | US
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Telephone | 502-434-7575
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Fax |
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Provider Business Mailing Address
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Address Line | 1218 MEADOWRIDGE TRL
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City | GOSHEN
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State | KY
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Zip | 40026-9517
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Country | US
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Telephone | 502-262-9288
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 267548
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License Number State | KY
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