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General NPI Number Information
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NPI Number | 1457249229
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Entity Type | Individual
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Provider Name | HOLLEY REBECCA GORDON MOT, OTR/L, CBIS
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Gender | Female
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Dates
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Enumeration Date | 06/27/2025
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Last Update Date | 07/03/2025
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Provider Practice Location Address
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Address Line | 909 N WASHINGTON AVE
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City | DALLAS
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State | TX
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Zip | 75246-1520
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Country | US
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Telephone | 214-820-8819
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Fax |
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Provider Business Mailing Address
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Address Line | 1101 HORIZON TRL
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City | RICHARDSON
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State | TX
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Zip | 75081-4358
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Country | US
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Telephone |
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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 | 225XN1300X
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Taxonomy Name | Neurorehabilitation Occupational Therapist
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License Number |
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License Number State |
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