Provider Demographics
NPI:1184165839
Name:HAZLEWOOD, RACHEL D (OTR)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:D
Last Name:HAZLEWOOD
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24025 KINGWOOD PLACE DR
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-3862
Mailing Address - Country:US
Mailing Address - Phone:281-312-4400
Mailing Address - Fax:
Practice Address - Street 1:24025 KINGWOOD PLACE DR
Practice Address - Street 2:ATTN: REHAB DEPT
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-3862
Practice Address - Country:US
Practice Address - Phone:281-312-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-14
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX118204225XG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology