Provider Demographics
NPI:1275229056
Name:HAGGARD, RACHEL LYNN (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:LYNN
Last Name:HAGGARD
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1413 FINGER LKS
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45458-3123
Mailing Address - Country:US
Mailing Address - Phone:859-496-4333
Mailing Address - Fax:
Practice Address - Street 1:3218 INDIAN RIPPLE RD
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45440-3637
Practice Address - Country:US
Practice Address - Phone:937-426-8481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-13
Last Update Date:2023-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH011486225X00000X
OHOT011486225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist