Provider Demographics
NPI:1821569385
Name:NELSON, RACHEL (ATR)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:NELSON
Suffix:
Gender:F
Credentials:ATR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4601 N VIA ENTRADA APT 1029
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-7617
Mailing Address - Country:US
Mailing Address - Phone:520-955-7995
Mailing Address - Fax:
Practice Address - Street 1:101 W 6TH ST # J
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85701-1000
Practice Address - Country:US
Practice Address - Phone:520-955-7995
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-10
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
14-205221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist