Provider Demographics
NPI:1376110742
Name:MCKINNEY, RACHEL STEVENSON (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:STEVENSON
Last Name:MCKINNEY
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:ANNE
Other - Last Name:STEVENSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:57 CRESTVIEW DR
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04103-2226
Mailing Address - Country:US
Mailing Address - Phone:904-325-3858
Mailing Address - Fax:
Practice Address - Street 1:23 WESTMINSTER ST
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-3531
Practice Address - Country:US
Practice Address - Phone:207-777-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-05
Last Update Date:2021-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
METO4092225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist