Provider Demographics
NPI:1144684135
Name:LILLQUIST, REBECCA ELIZABETH (OTR/L)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:ELIZABETH
Last Name:LILLQUIST
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1166 MARYLAND RT. 3 SOUTH
Mailing Address - Street 2:SUITE 109
Mailing Address - City:GAMBRILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21054
Mailing Address - Country:US
Mailing Address - Phone:410-451-5700
Mailing Address - Fax:410-451-5703
Practice Address - Street 1:8717 GREENBELT RD.
Practice Address - Street 2:SUITE 102
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770
Practice Address - Country:US
Practice Address - Phone:301-552-2371
Practice Address - Fax:410-451-5703
Is Sole Proprietor?:No
Enumeration Date:2016-04-06
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MD08138225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics