Provider Demographics
NPI:1821571266
Name:COHEN, RACHAEL JEAN (CPM)
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:JEAN
Last Name:COHEN
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:194 MAIN ST STE 104
Mailing Address - Street 2:
Mailing Address - City:ELLSWORTH
Mailing Address - State:ME
Mailing Address - Zip Code:04605-1939
Mailing Address - Country:US
Mailing Address - Phone:207-479-3620
Mailing Address - Fax:
Practice Address - Street 1:194 MAIN ST STE 104
Practice Address - Street 2:
Practice Address - City:ELLSWORTH
Practice Address - State:ME
Practice Address - Zip Code:04605-1939
Practice Address - Country:US
Practice Address - Phone:207-479-3620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-12
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife