Provider Demographics
NPI:1093027229
Name:HART, RACHEAL ANN (MS, OT)
Entity Type:Individual
Prefix:
First Name:RACHEAL
Middle Name:ANN
Last Name:HART
Suffix:
Gender:F
Credentials:MS, OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 W 15TH AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99501-5128
Mailing Address - Country:US
Mailing Address - Phone:907-290-3377
Mailing Address - Fax:
Practice Address - Street 1:203 W 15TH AVE STE 105
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99501-5128
Practice Address - Country:US
Practice Address - Phone:907-441-5214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-02
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK2090225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist