Healthcare Provider Details

I. General information

NPI: 1245806108
Provider Name (Legal Business Name): RACHEL LYNN PHILLIPS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2021
Last Update Date: 06/01/2021
Certification Date: 06/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 BOWER HILL RD
PITTSBURGH PA
15243-2040
US

IV. Provider business mailing address

591 ELMWOOD AVE
WASHINGTON PA
15301-2848
US

V. Phone/Fax

Practice location:
  • Phone: 412-341-1030
  • Fax:
Mailing address:
  • Phone: 724-914-9389
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224ZE0001X
TaxonomyEnvironmental Modification Occupational Therapy Assistant
License Number
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: