Provider Demographics
NPI:1457808743
Name:SCHOMMER, RACHAEL MARIA (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:RACHAEL
Middle Name:MARIA
Last Name:SCHOMMER
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:MS
Other - First Name:RACHAEL
Other - Middle Name:
Other - Last Name:BAHNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA/L
Mailing Address - Street 1:41 E MAIN ST FL 2
Mailing Address - Street 2:
Mailing Address - City:MYSTIC
Mailing Address - State:CT
Mailing Address - Zip Code:06355-2831
Mailing Address - Country:US
Mailing Address - Phone:717-277-1986
Mailing Address - Fax:
Practice Address - Street 1:41 E MAIN ST FL 2
Practice Address - Street 2:
Practice Address - City:MYSTIC
Practice Address - State:CT
Practice Address - Zip Code:06355-2831
Practice Address - Country:US
Practice Address - Phone:717-277-1986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-05
Last Update Date:2016-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001742224Z00000X
RIOTA00901224Z00000X
MA3372224Z00000X
PAOP008322224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant