Provider Demographics
NPI:1891068326
Name:WERENSKI, RACHEL ANNE (OT)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:ANNE
Last Name:WERENSKI
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4180 BURNT HICKORY RD NW
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30064-1134
Mailing Address - Country:US
Mailing Address - Phone:770-443-9672
Mailing Address - Fax:
Practice Address - Street 1:3044 DUE WEST RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:GA
Practice Address - Zip Code:30157-2125
Practice Address - Country:US
Practice Address - Phone:770-443-9672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-14
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT005411225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist