Provider Demographics
NPI:1831543529
Name:GRZYWA, RACHAEL E (OTR/L)
Entity type:Individual
Prefix:
First Name:RACHAEL
Middle Name:E
Last Name:GRZYWA
Suffix:
Gender:
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2323 N CASALOMA DR
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54913-8284
Mailing Address - Country:US
Mailing Address - Phone:920-730-8833
Mailing Address - Fax:
Practice Address - Street 1:2323 N CASALOMA DR
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54913-8284
Practice Address - Country:US
Practice Address - Phone:207-308-8833
Practice Address - Fax:920-738-9089
Is Sole Proprietor?:No
Enumeration Date:2016-04-19
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5576-26225XH1200X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand