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General NPI Number Information
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NPI Number | 1366351637
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Entity Type | Individual
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Provider Name | RACHEL DANIELLE DIFFENBAUGH
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Gender | Female
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Dates
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Enumeration Date | 09/03/2026
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Last Update Date | 09/03/2026
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Provider Practice Location Address
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Address Line | 4251 MONUMENT RD APT 302
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City | JACKSONVILLE
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State | FL
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Zip | 32225-4623
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Country | US
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Telephone | 904-923-3512
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Fax |
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Provider Business Mailing Address
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Address Line | 4251 MONUMENT RD APT 302
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City | JACKSONVILLE
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State | FL
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Zip | 32225-4623
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Country | US
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Telephone |
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA85619
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License Number State | FL
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