Provider Demographics
NPI:1174837090
Name:DAILEY THOMSEN, REBECCA KATHLEEN (OTR/L)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:KATHLEEN
Last Name:DAILEY THOMSEN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 GREENWOOD ST.
Mailing Address - Street 2:
Mailing Address - City:LAKE PLACID
Mailing Address - State:NY
Mailing Address - Zip Code:12946
Mailing Address - Country:US
Mailing Address - Phone:518-523-4354
Mailing Address - Fax:
Practice Address - Street 1:34 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:LAKE PLACID
Practice Address - State:NY
Practice Address - Zip Code:12946-3323
Practice Address - Country:US
Practice Address - Phone:518-523-2474
Practice Address - Fax:518-523-2707
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-03
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist