Provider Demographics
NPI:1891957866
Name:GOSSELIN, RACHEL HELENA (LMT)
Entity Type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:HELENA
Last Name:GOSSELIN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 HALIFAX ST APT 2
Mailing Address - Street 2:
Mailing Address - City:WINSLOW
Mailing Address - State:ME
Mailing Address - Zip Code:04901-7450
Mailing Address - Country:US
Mailing Address - Phone:207-660-3210
Mailing Address - Fax:
Practice Address - Street 1:66 EASTERN AVE
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-5837
Practice Address - Country:US
Practice Address - Phone:207-620-8291
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-30
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMT3210225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist