Basic Information
| Provider Information | |||||||||
| NPI: | 1184678385 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | O'BRYAN | ||||||||
| FirstName: | REBECCA | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | OTR | ||||||||
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| Mailing Information | |||||||||
| Address1: | 901 DULANEY VALLEY RD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | TOWSON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212042600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103374500 | ||||||||
| FaxNumber: | 4103397326 | ||||||||
| Practice Location | |||||||||
| Address1: | 3916 PLANK RD | ||||||||
| Address2: | |||||||||
| City: | FREDERICKSBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 224076839 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5407863900 | ||||||||
| FaxNumber: | 5407850087 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/20/2006 | ||||||||
| LastUpdateDate: | 02/24/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 0119003038 | VA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.