MEDICARE: RACHEL MOFFAT

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	104100000X	Social Worker		OH

General Provider Information

NPI Number	:	1962999748
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL MOFFAT

Provider Business Mailing Address
First Line	:	5481 N MEADOWS BLVD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43229-4132
Country	:	US
Telephone Number	:	614-330-5990
Fax Number	:

Provider Business Practice Location Address
First Line	:	5481 N MEADOWS BLVD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43229-4132
Country	:	US
Telephone Number	:	614-330-5990
Fax Number	:

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

Provider Enumeration Date	:	04/17/2018
Last Update Date	:	04/17/2018

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Directions to “ RACHEL MOFFAT ” Practice Location

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