Provider Demographics
NPI:1174865471
Name:WOOTERS, RACHEL SCOTT (MA, RD, LDN,)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:SCOTT
Last Name:WOOTERS
Suffix:
Gender:F
Credentials:MA, RD, LDN,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MEDICAL CENTER BLVD
Mailing Address - Street 2:POB II, SUITE
Mailing Address - City:CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19013-3902
Mailing Address - Country:US
Mailing Address - Phone:610-619-8455
Mailing Address - Fax:610-619-8451
Practice Address - Street 1:1 MEDICAL CENTER BLVD
Practice Address - Street 2:POB II, SUITE 326
Practice Address - City:CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19013-3902
Practice Address - Country:US
Practice Address - Phone:610-619-8450
Practice Address - Fax:610-619-8451
Is Sole Proprietor?:No
Enumeration Date:2013-03-25
Last Update Date:2014-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA965013133VN1006X
PADN004026133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic