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General NPI Number Information
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NPI Number | 1568602241
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Entity Type | Individual
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Provider Name | RACHEL L COHEN ATC, LAT, EMT
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Gender | Female
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Dates
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Enumeration Date | 02/20/2009
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Last Update Date | 02/20/2009
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Provider Practice Location Address
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Address Line | 110 WOODBURY RD
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City | WATERTOWN
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State | CT
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Zip | 06795-2130
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Country | US
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Telephone | 860-945-7806
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Fax |
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Provider Business Mailing Address
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Address Line | 925 ORONOKE RD 101L
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City | WATERBURY
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State | CT
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Zip | 06708-3945
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Country | US
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Telephone | 860-306-4166
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 080602170
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License Number State | CT
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