Healthcare Provider Details

I. General information

NPI: 1609545250
Provider Name (Legal Business Name): RACHEL ANN BOSSI MSOT, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2021
Last Update Date: 10/05/2021
Certification Date: 10/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 ANDOVER RD
WESTBROOK ME
04092-3850
US

IV. Provider business mailing address

123 ANDOVER RD
WESTBROOK ME
04092-3850
US

V. Phone/Fax

Practice location:
  • Phone: 207-761-2200
  • Fax:
Mailing address:
  • Phone: 207-761-2200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT4147
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code225XM0800X
TaxonomyMental Health Occupational Therapist
License NumberOT4147
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: