MEDICARE: REBECCA MIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1083261515
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA MIN

Provider Business Mailing Address
First Line	:	8348 TRAFORD LN
Second Line	:
City	:	SPRINGFIELD
State	:	VA
Zip	:	22152-1663
Country	:	US
Telephone Number	:	703-569-7500
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 CARPENTER DR STE 140
Second Line	:
City	:	STERLING
State	:	VA
Zip	:	20164-4464
Country	:	US
Telephone Number	:	703-707-9060
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/20/2019
Last Update Date	:	08/20/2019

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Directions to “ REBECCA MIN ” Practice Location

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