=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982110383
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RACHEL ELIZABETH ENGELHARDT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/20/2017
-----------------------------------------------------
Last Update Date | 02/01/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1 DANBRIDGE DR
-----------------------------------------------------
City | HORSHAM
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19044-1031
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-514-9715
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1 DANBRIDGE DR
-----------------------------------------------------
City | HORSHAM
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19044-1031
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-514-9715
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number | OC015345
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------