Provider Demographics
NPI:1801252465
Name:RIVERA, RACHEL
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:RIVERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1
Mailing Address - Street 2:
Mailing Address - City:EAST DERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03041-0001
Mailing Address - Country:US
Mailing Address - Phone:404-409-4474
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 1
Practice Address - Street 2:
Practice Address - City:EAST DERRY
Practice Address - State:NH
Practice Address - Zip Code:03041-0001
Practice Address - Country:US
Practice Address - Phone:404-409-4474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-12
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL17430225X00000X
NH3834225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist