Provider Demographics
NPI:1205483724
Name:SCHAEFFER, RAELEAH MARIE (MOT, OTR/L)
Entity type:Individual
Prefix:
First Name:RAELEAH
Middle Name:MARIE
Last Name:SCHAEFFER
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 N 2ND ST W
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59802-2919
Mailing Address - Country:US
Mailing Address - Phone:262-501-3901
Mailing Address - Fax:406-519-0626
Practice Address - Street 1:1270 TROTTING HORSE LN
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59804-9770
Practice Address - Country:US
Practice Address - Phone:406-209-9847
Practice Address - Fax:406-519-0626
Is Sole Proprietor?:No
Enumeration Date:2019-08-20
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTOTP-OT-LIC-6976225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist