Provider Demographics
NPI:1184233744
Name:RACHEL TRAILL OCCUPATIONAL THERAPY LLC
Entity type:Organization
Organization Name:RACHEL TRAILL OCCUPATIONAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:TRAILL
Authorized Official - Suffix:
Authorized Official - Credentials:MOT, OT/L
Authorized Official - Phone:772-370-5549
Mailing Address - Street 1:4704 SW GOSSAMER CIR
Mailing Address - Street 2:
Mailing Address - City:PALM CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34990-1562
Mailing Address - Country:US
Mailing Address - Phone:772-370-5549
Mailing Address - Fax:
Practice Address - Street 1:4203 SW HIGH MEADOWS AVE
Practice Address - Street 2:
Practice Address - City:PALM CITY
Practice Address - State:FL
Practice Address - Zip Code:34990-3726
Practice Address - Country:US
Practice Address - Phone:772-370-5549
Practice Address - Fax:772-419-7113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-29
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty