Individual
REBECCA CISZEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOTR/L
Contact information
Practice address
192 BYRON RD, GERRARDSTOWN, WV 25420-4594
(708) 275-4752
Mailing address
192 BYRON RD, GERRARDSTOWN, WV 25420-4594
(708) 275-4752
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119006509
VA
225X00000X
Occupational Therapist
1784
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011900659
LICENSE OF OCCUPATIONAL THERAPY
VA
01
—
1784
LISCENCE OF OT
WV
Enumeration date
12/08/2015
Last updated
12/08/2015
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