Healthcare Provider Details

I. General information

NPI: 1003729781
Provider Name (Legal Business Name): RACHEL JOHNSON OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1780 WEHRLE DR STE 110
BUFFALO NY
14221-7000
US

IV. Provider business mailing address

2900 DELAWARE AVE
KENMORE NY
14217-2309
US

V. Phone/Fax

Practice location:
  • Phone: 716-871-9915
  • Fax: 716-871-9887
Mailing address:
  • Phone: 716-871-9915
  • Fax: 716-871-9887

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number027067
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: