Wagner, Rachelle
Wagner, Rachelle is an individual health care provider with primary practice located at 304 E 6Th Ave , Rome GA 30161-6000. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Contractor, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist. Other Service Providers / Contractor is her primary health care specialty. Wagner, Rachelle can be contacted via phone (706) 378-9044.Contact Information
Primary practice address
304 E 6Th Ave
Rome GA 30161-6000
Phone: (706) 378-9044
Fax: (706) 378-9046
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Contractor | 171W00000X | OT003702 | Georgia |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist | 225X00000X | OT003702 | Georgia |
Profile Details
| NPI number | 1841364999 |
|---|---|
| LBN Legal business name | Wagner, Rachelle |
| Credentials | OTRL |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 20th, 2006 |
| Last updated | Jul 9th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1841364999 | NPPES |
| Georgia | MEDICAID | 10047143 | |
| Georgia | MEDICAID | 342685 | |
| Georgia | Other | 52038467 |
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