Provider Demographics
NPI:1679848410
Name:GEORGE, RACHEL ANNE
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:ANNE
Last Name:GEORGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:ANNE
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1314 N FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:61832-2503
Mailing Address - Country:US
Mailing Address - Phone:217-390-8483
Mailing Address - Fax:
Practice Address - Street 1:1314 N FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:IL
Practice Address - Zip Code:61832-2503
Practice Address - Country:US
Practice Address - Phone:217-390-8483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-13
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist