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General NPI Number Information
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NPI Number | 1497967905
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Entity Type | Organization
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Legal Business Name | RACHEL TRAILL OCCUPATIONAL THERAPY LLC
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1330 NE JENSEN BEACH BLVD
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City | JENSEN BEACH
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State | FL
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Zip | 34950
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Country | US
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Telephone | 772-370-5549
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Fax | 772-781-4407
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Provider Business Mailing Address
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Address Line | 2686 SW REGENCY ROAD
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City | STUART
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State | FL
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Zip | 34997-1223
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Country | US
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Telephone | 772-370-5549
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Fax | 772-781-4407
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Authorized Official
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Title or Position | OWNER
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Name | MRS. RACHEL LYNN TRAILL
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Credential | OT
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Telephone | 772-370-5549
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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 | OT9579
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License Number State | FL
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