Healthcare Provider Details

I. General information

NPI: 1023712700
Provider Name (Legal Business Name): RACHEL EWING OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RACHEL PULLEY

II. Dates (important events)

Enumeration Date: 03/28/2023
Last Update Date: 03/28/2023
Certification Date: 03/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 TAYLOR CT
STEPHENSON VA
22656-2235
US

IV. Provider business mailing address

117 TAYLOR CT
STEPHENSON VA
22656-2235
US

V. Phone/Fax

Practice location:
  • Phone: 301-717-4369
  • Fax:
Mailing address:
  • Phone: 301-717-4369
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: