Provider Demographics
NPI:1023273034
Name:KEATON, REBECCA ANN (OTR)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:ANN
Last Name:KEATON
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1008 NIMITZ CT
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89002-9240
Mailing Address - Country:US
Mailing Address - Phone:702-845-6727
Mailing Address - Fax:702-734-6655
Practice Address - Street 1:1008 NIMITZ CT
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89002-9240
Practice Address - Country:US
Practice Address - Phone:702-845-6727
Practice Address - Fax:702-734-6655
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-20
Last Update Date:2008-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0823225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics