Healthcare Provider Details

I. General information

NPI: 1477422830
Provider Name (Legal Business Name): RACHEL ROTHBARDT HENDERSON M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2025
Last Update Date: 11/03/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 S UNIVERSITY BLVD STE 2000
MOBILE AL
36608-3271
US

IV. Provider business mailing address

2075 WINNERS CIR
CANTONMENT FL
32533-5731
US

V. Phone/Fax

Practice location:
  • Phone: 251-460-7149
  • Fax:
Mailing address:
  • Phone: 251-597-6901
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: