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Individual

REBECCA NICOLE MCCLELLAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA, OTR/L

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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