Provider Demographics
NPI:1174923148
Name:KEMPA, REBECCA MARIE (DPT)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:MARIE
Last Name:KEMPA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:M
Other - Last Name:MCCULLOUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:600 PLAZA CT
Mailing Address - Street 2:
Mailing Address - City:EAST STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18301-8263
Mailing Address - Country:US
Mailing Address - Phone:570-517-0511
Mailing Address - Fax:570-421-7091
Practice Address - Street 1:24569 ROUTE 6
Practice Address - Street 2:SUITE C
Practice Address - City:TOWANDA
Practice Address - State:PA
Practice Address - Zip Code:18848-8254
Practice Address - Country:US
Practice Address - Phone:570-265-1111
Practice Address - Fax:570-265-7134
Is Sole Proprietor?:No
Enumeration Date:2014-08-27
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT023823225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist