Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 0688 | NV |
N | 2251P0200X | Physical Therapist - Pediatrics | 16414 | CA |
NPI | 1093899502 |
---|---|
Provider Name | Ms. Rebecca Anne Mcfadden |
First Address | Tahoe City, CA 96145-7523 |
Second Address | Reno, NV 89521-8909 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
XPT000400 | (05) | CA |