Individual
REBECCA NICOLE MCCLELLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, OTR/L
Contact information
Practice address
5406 MERLE HAY RD, JOHNSTON, IA 50131-1209
(515) 727-8750
(515) 727-8757
Mailing address
5406 MERLE HAY RD, JOHNSTON, IA 50131-1209
(515) 727-8750
(515) 727-8757
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
095084
IA
225X00000X
Occupational Therapist
Primary
105649
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
JZQ128135634001
BLUE CROSS BLUE SHIELD
MN
Enumeration date
06/06/2018
Last updated
05/05/2021
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