Healthcare Provider Details

I. General information

NPI: 1104772003
Provider Name (Legal Business Name): RACHEL BENJAMIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2026
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

749 DUNKINS FERRY RD
ROCK HILL SC
29730-0190
US

IV. Provider business mailing address

6093 LAURENT AVE
FORT MILL SC
29715-8394
US

V. Phone/Fax

Practice location:
  • Phone: 803-680-1400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number6455
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: