MEDICARE: RACHEL NICOLE PLANT OTR/L

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	225X00000X	Occupational Therapist	5885	AZ
2	225X00000X	Occupational Therapist	056.009972	IL

General Provider Information

NPI Number	:	1801203260
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL NICOLE PLANT OTR/L

Provider Business Mailing Address
First Line	:	PO BOX 11375
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85284-0023
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 E SOUTHERN AVE
Second Line	:	SUITE 310
City	:	TEMPE
State	:	AZ
Zip	:	85282-5691
Country	:	US
Telephone Number	:	877-279-0891
Fax Number	:

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

Provider Enumeration Date	:	07/17/2014
Last Update Date	:	07/17/2014

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