Provider Demographics
NPI:1316563323
Name:GALLEGOS, RACHEL RAY-ANNE (LMT)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:RAY-ANNE
Last Name:GALLEGOS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:RAY-ANNE
Other - Last Name:STRAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:13113 KNIGHT ISLAND DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73142-8607
Mailing Address - Country:US
Mailing Address - Phone:405-371-2007
Mailing Address - Fax:
Practice Address - Street 1:1900 NW EXPRESSWAY STE R206
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73118-1849
Practice Address - Country:US
Practice Address - Phone:405-371-2007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-25
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK173865225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist