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General NPI Number Information
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NPI Number | 1932965399
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Entity Type | Individual
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Provider Name | REBECCA LYNN BRACKIN OTD, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 02/23/2024
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Last Update Date | 02/23/2024
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Provider Practice Location Address
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Address Line | 100 STATE CIR
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City | ANNAPOLIS
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State | MD
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Zip | 21401-1924
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Country | US
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Telephone | 877-407-3422
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Fax |
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Provider Business Mailing Address
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Address Line | 1400 S JOYCE ST APT 236
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City | ARLINGTON
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State | VA
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Zip | 22202-1809
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Country | US
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Telephone | 302-279-6289
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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 | 10188
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License Number State | MD
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