Provider Demographics
NPI:1568602241
Name:COHEN, RACHEL L (ATC, LAT, EMT)
Entity Type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:L
Last Name:COHEN
Suffix:
Gender:F
Credentials:ATC, LAT, EMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 ORONOKE RD
Mailing Address - Street 2:101L
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06708-3945
Mailing Address - Country:US
Mailing Address - Phone:860-306-4166
Mailing Address - Fax:
Practice Address - Street 1:110 WOODBURY RD
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:CT
Practice Address - Zip Code:06795-2130
Practice Address - Country:US
Practice Address - Phone:860-945-7806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-20
Last Update Date:2009-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0806021702255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer