Basic Information
| Provider Information | |||||||||
| NPI: | 1013382944 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WIGGERS | ||||||||
| FirstName: | RACHEL | ||||||||
| MiddleName: | MARIE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | OTR/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1100 SHAWNEE ROAD | ||||||||
| Address2: | |||||||||
| City: | LIMA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 45805 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4199992030 | ||||||||
| FaxNumber: | 4199910909 | ||||||||
| Practice Location | |||||||||
| Address1: | 640 WORTH ST | ||||||||
| Address2: | |||||||||
| City: | CORRY | ||||||||
| State: | PA | ||||||||
| PostalCode: | 164078515 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8146649606 | ||||||||
| FaxNumber: | 8146650036 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/03/2015 | ||||||||
| LastUpdateDate: | 12/03/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | OC010497 | PA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.