Provider Demographics
NPI:1497501514
Name:NAREDO, REBECA (OTR/L)
Entity type:Individual
Prefix:
First Name:REBECA
Middle Name:
Last Name:NAREDO
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:REBECA
Other - Middle Name:
Other - Last Name:NAREDO RAYMOND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1020 CENTRAL PKWY S
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-5021
Mailing Address - Country:US
Mailing Address - Phone:210-798-2273
Mailing Address - Fax:210-495-1479
Practice Address - Street 1:1020 CENTRAL PKWY S
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-5021
Practice Address - Country:US
Practice Address - Phone:210-798-2273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-29
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX124517225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist