Provider Demographics
NPI:1790814093
Name:RADCLIFFE, RACHEL KATHRYN (MS, OTR/L, IBCLC)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:KATHRYN
Last Name:RADCLIFFE
Suffix:
Gender:F
Credentials:MS, OTR/L, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9115 KIRKDALE RD
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-3301
Mailing Address - Country:US
Mailing Address - Phone:202-710-7040
Mailing Address - Fax:
Practice Address - Street 1:9115 KIRKDALE RD
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-3301
Practice Address - Country:US
Practice Address - Phone:202-710-7040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-04
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCOT010000445225X00000X
L-89134174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist