Provider Demographics
NPI:1821798521
Name:LATOUR, RACHELLE (OTR/L)
Entity type:Individual
Prefix:
First Name:RACHELLE
Middle Name:
Last Name:LATOUR
Suffix:
Gender:F
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:PO BOX 10016
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92375-3216
Mailing Address - Country:US
Mailing Address - Phone:909-883-5069
Mailing Address - Fax:
Practice Address - Street 1:401 E BOGARD RD
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-7108
Practice Address - Country:US
Practice Address - Phone:907-357-2578
Practice Address - Fax:907-357-2529
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-09
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK223422225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty