Provider Demographics
NPI:1891493953
Name:CANTRELL, RACHAEL ELIZABETH (MS OTR/L)
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:ELIZABETH
Last Name:CANTRELL
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:658 MAPLE GROVE WAY
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-5823
Mailing Address - Country:US
Mailing Address - Phone:404-455-1786
Mailing Address - Fax:
Practice Address - Street 1:658 MAPLE GROVE WAY
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30066-5823
Practice Address - Country:US
Practice Address - Phone:404-455-1786
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-17
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT006035225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist