Provider Demographics
NPI:1750855441
Name:GREEN, RACHEL LEIGH (MS OTR/L)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:LEIGH
Last Name:GREEN
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 PONEMAH HILL RD APT 2-210
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03055-8956
Mailing Address - Country:US
Mailing Address - Phone:203-915-7245
Mailing Address - Fax:
Practice Address - Street 1:522 AMHERST ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03063-1019
Practice Address - Country:US
Practice Address - Phone:603-880-0448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-15
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2805225X00000X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist