Provider Demographics
NPI:1811027782
Name:CRACKNELL, RACHAEL LEE
Entity Type:Individual
Prefix:MS
First Name:RACHAEL
Middle Name:LEE
Last Name:CRACKNELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 GARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02144-1711
Mailing Address - Country:US
Mailing Address - Phone:617-628-2489
Mailing Address - Fax:
Practice Address - Street 1:530 BORDER ST
Practice Address - Street 2:
Practice Address - City:EAST BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02128-2432
Practice Address - Country:US
Practice Address - Phone:617-569-6560
Practice Address - Fax:617-569-1856
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical