Provider Demographics
NPI:1740863729
Name:OLSEN, RACHEL (RD)
Entity type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:
Last Name:OLSEN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1629 28TH AVE S
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:AL
Mailing Address - Zip Code:35209-1701
Mailing Address - Country:US
Mailing Address - Phone:205-246-7412
Mailing Address - Fax:
Practice Address - Street 1:1629 28TH AVE S
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:AL
Practice Address - Zip Code:35209-1701
Practice Address - Country:US
Practice Address - Phone:205-246-7412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-28
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT86060133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered