Provider Demographics
NPI:1447831565
Name:KLOCKARS, REBECCA LEE (OTR/L)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:LEE
Last Name:KLOCKARS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:LEE
Other - Last Name:FRIEDMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:800 QUAKER LN
Mailing Address - Street 2:
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818-1698
Mailing Address - Country:US
Mailing Address - Phone:401-886-6600
Mailing Address - Fax:401-886-6632
Practice Address - Street 1:800 QUAKER LN
Practice Address - Street 2:
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-1667
Practice Address - Country:US
Practice Address - Phone:401-886-6600
Practice Address - Fax:401-886-6632
Is Sole Proprietor?:No
Enumeration Date:2021-04-20
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIOT00876225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist