Provider Demographics
NPI:1477825867
Name:DUFFY, RACHEL ANN (OTR)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:ANN
Last Name:DUFFY
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4401 LAKE SUMMER PL
Mailing Address - Street 2:
Mailing Address - City:MOSELEY
Mailing Address - State:VA
Mailing Address - Zip Code:23120-2212
Mailing Address - Country:US
Mailing Address - Phone:215-915-6693
Mailing Address - Fax:
Practice Address - Street 1:301 N 9TH ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23219
Practice Address - Country:US
Practice Address - Phone:804-780-7911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-01
Last Update Date:2018-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119006536225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN4600402OtherMEDICA
MN76842OtherHEALTHPARTNERS
MN001442700Medicaid
MN1311578OtherCIGNA
MN169036OtherUCARE
MN16154051OtherFISERV
MN565581028803OtherPREFERRED ONE
MN78B64KIOtherBCBS MN