Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 0119007646 | VA |
N | 225X00000X | Occupational Therapist | 11634 | NC |
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 11634 | NC |
NPI | 1932602075 |
---|---|
Provider Name | Rebecca Tupaj |
First Address | Camp Lejeune, NC 28547-2575 |
Second Address | Camp Lejeune, NC 28547-2575 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2018 |
Last Update Date | 26/11/2019 |