Basic Information
| Provider Information | |||||||||
| NPI: | 1750735098 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SUYDAM | ||||||||
| FirstName: | RACHEL | ||||||||
| MiddleName: | BATY | ||||||||
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| Credential: | MS, OTR/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1900 VANCE STREET | ||||||||
| Address2: | APT. 124 | ||||||||
| City: | WESTMINSTER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 80021 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6103348723 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6270 W 38TH AVE | ||||||||
| Address2: | |||||||||
| City: | WHEAT RIDGE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800335056 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3034212272 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/22/2016 | ||||||||
| LastUpdateDate: | 04/22/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | OT.0004612 | CO | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.