Basic Information
Provider Information
NPI: 1457407827
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PARISH
FirstName: RACHAEL
MiddleName: JOY
NamePrefix: MRS.
NameSuffix:  
Credential: COTAL
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 107 CHESTNUT DR
Address2:  
City: DICKSON
State: TN
PostalCode: 370559044
CountryCode: US
TelephoneNumber: 6154412711
FaxNumber: 6154413138
Practice Location
Address1: 812 N CHARLOTTE ST
Address2:  
City: DICKSON
State: TN
PostalCode: 370551009
CountryCode: US
TelephoneNumber: 6154468046
FaxNumber: 6154413138
Other Information
ProviderEnumerationDate: 01/26/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
224Z00000XCOTA1614TNY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant 

No ID Information.


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