Moore, Rebecca Dawn

Moore, Rebecca Dawn is an sole proprietor health care provider with primary practice located at 200 Gaston Ave , Fairmont WV 26554-2739. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as her primary health care specialty. Moore, Rebecca Dawn can be contacted via phone (304) 624-6554.

Contact Information

Primary practice address
200 Gaston Ave Fairmont WV 26554-2739
Phone: (304) 624-6554
Fax: (304) 624-5223
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X West Virginia

Profile Details

NPI number 1366612467
LBN Legal business name Moore, Rebecca Dawn
Credentials OTR/L
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 4th, 2008
Last updated Mar 4th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366612467 NPPES
West Virginia MEDICAID 7502011000

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