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General NPI Number Information
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NPI Number | 1053508051
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Entity Type | Individual
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Provider Name | RACHEL DURNIN
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Gender | Female
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Dates
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Enumeration Date | 10/03/2007
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Last Update Date | 10/03/2007
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Provider Practice Location Address
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Address Line | 150 LONG RD SUITE 150
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City | CHESTERFIELD
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State | MO
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Zip | 63005-1235
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Country | US
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Telephone | 636-733-3330
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Fax |
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Provider Business Mailing Address
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Address Line | 8560 GINGER DR
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City | SAINT LOUIS
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State | MO
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Zip | 63114-4413
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Country | US
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Telephone | 636-733-3330
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 2007028415
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License Number State | MO
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