Provider Demographics
NPI:1528381910
Name:DORMAN, RACHEL (MOT,OTR)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:DORMAN
Suffix:
Gender:F
Credentials:MOT,OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11880 GREENVILLE AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-0587
Mailing Address - Country:US
Mailing Address - Phone:214-349-6178
Mailing Address - Fax:
Practice Address - Street 1:11880 GREENVILLE AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-0587
Practice Address - Country:US
Practice Address - Phone:214-349-6178
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-12
Last Update Date:2010-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113514225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics