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General NPI Number Information
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NPI Number | 1578285490
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Entity Type | Individual
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Provider Name | RACHEL LACEY WHEELER MOTR/L
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Gender | Female
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Dates
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Enumeration Date | 09/16/2022
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Last Update Date | 09/16/2022
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Provider Practice Location Address
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Address Line | 1151 W WILSON ST
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City | BANNING
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State | CA
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Zip | 92220-4378
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Country | US
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Telephone | 951-922-0020
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Fax |
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Provider Business Mailing Address
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Address Line | 36360 EAGLE LN
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City | BEAUMONT
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State | CA
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Zip | 92223-8047
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Country | US
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Telephone | 909-782-8953
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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 | 15526
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License Number State | CA
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