Provider Demographics
NPI:1407184518
Name:HANSEN, RACHEL JEAN (MS,OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:JEAN
Last Name:HANSEN
Suffix:
Gender:F
Credentials:MS,OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1540 BLUEBIRD AVE
Mailing Address - Street 2:
Mailing Address - City:MANNING
Mailing Address - State:IA
Mailing Address - Zip Code:51455-7520
Mailing Address - Country:US
Mailing Address - Phone:712-782-6818
Mailing Address - Fax:
Practice Address - Street 1:1501 E 10TH ST
Practice Address - Street 2:
Practice Address - City:ATLANTIC
Practice Address - State:IA
Practice Address - Zip Code:50022-1936
Practice Address - Country:US
Practice Address - Phone:712-243-3250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-01
Last Update Date:2009-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01076225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist