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General NPI Number Information
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NPI Number | 1679965354
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Entity Type | Individual
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Provider Name | MISS REBECCA SKINNER
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Gender | Female
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Dates
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Enumeration Date | 03/04/2015
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Last Update Date | 03/04/2015
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Provider Practice Location Address
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Address Line | 9441 LBJ FREEWAY SUITE 602
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City | DALLAS
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State | TX
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Zip | 75243
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Country | US
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Telephone | 469-708-3998
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Fax |
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Provider Business Mailing Address
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Address Line | 3501 SHORELINE DR APT 425
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City | AUSTIN
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State | TX
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Zip | 78728-4486
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Country | US
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Telephone | 716-499-3318
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 8985
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License Number State | NC
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