Provider Demographics
NPI:1942330378
Name:THOMPSON, RACHEL BROOK (OTRL)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:BROOK
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3050 YORK LN
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-8344
Mailing Address - Country:US
Mailing Address - Phone:501-733-8498
Mailing Address - Fax:
Practice Address - Street 1:1700 SOUTH BLVD
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-6455
Practice Address - Country:US
Practice Address - Phone:501-329-8102
Practice Address - Fax:501-329-2133
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR2033225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics