MEDICARE: RACHEL KO MASTERS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	00145	RI
2	101Y00000X	Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356671960
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL KO MASTERS

Provider Business Mailing Address
First Line	:	186 STUBBLE BROOK RD
Second Line	:
City	:	WEST GREENWICH
State	:	RI
Zip	:	02817-2068
Country	:	US
Telephone Number	:	401-699-2234
Fax Number	:

Provider Business Practice Location Address
First Line	:	186 STUBBLE BROOK RD
Second Line	:
City	:	WEST GREENWICH
State	:	RI
Zip	:	02817-2068
Country	:	US
Telephone Number	:	401-699-2234
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2010
Last Update Date	:	10/31/2019

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