Provider Demographics
NPI:1700300803
Name:MCRAE, RACHEL DIANE (COTA)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:DIANE
Last Name:MCRAE
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7443 LAKEHURST DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77087-6109
Mailing Address - Country:US
Mailing Address - Phone:713-884-6566
Mailing Address - Fax:
Practice Address - Street 1:7443 LAKEHURST DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77087-6109
Practice Address - Country:US
Practice Address - Phone:713-884-6566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX214049224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX360380OtherNATIONAL BOARD FOR CERTIFICATION IN OCCUPATIONAL THERAPY, INC.
TX214049OtherTEXAS BOARD OF OCCUPATIONAL THERAPY EXAMINERS