Provider Demographics
NPI:1487423091
Name:THIERRY, RACHEL N
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:N
Last Name:THIERRY
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 1:38 CUTTER COVE CT
Mailing Address - Street 2:
Mailing Address - City:MIDDLE RIVER
Mailing Address - State:MD
Mailing Address - Zip Code:21220-7509
Mailing Address - Country:US
Mailing Address - Phone:410-841-8453
Mailing Address - Fax:
Practice Address - Street 1:38 CUTTER COVE CT
Practice Address - Street 2:
Practice Address - City:MIDDLE RIVER
Practice Address - State:MD
Practice Address - Zip Code:21220-7509
Practice Address - Country:US
Practice Address - Phone:410-841-8453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-22
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD259361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical