Provider Demographics
NPI:1508529686
Name:LONJARET, RACHEL ELAINE (COTA/L)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:ELAINE
Last Name:LONJARET
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2575 W 24TH ST APT 273
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-6046
Mailing Address - Country:US
Mailing Address - Phone:501-658-0652
Mailing Address - Fax:
Practice Address - Street 1:2575 W 24TH ST APT 273
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-6046
Practice Address - Country:US
Practice Address - Phone:501-658-0652
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-15
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTA-046958224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant