Provider Demographics
NPI:1477043784
Name:LAND, RACHEL LOUISE (OTR/L)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:LOUISE
Last Name:LAND
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:LOUISE
Other - Last Name:BRUMM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:128 GARNER RD
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29303-3149
Mailing Address - Country:US
Mailing Address - Phone:414-759-4665
Mailing Address - Fax:
Practice Address - Street 1:128 GARNER RD
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-3149
Practice Address - Country:US
Practice Address - Phone:414-759-4665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-11
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY1179225X00000X
SC6511225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist