Provider Demographics
NPI:1104461524
Name:NEMATI, RACHEL PACE (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:PACE
Last Name:NEMATI
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 1:2900 PHARR COURT SOUTH NW APT 3106
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-4965
Mailing Address - Country:US
Mailing Address - Phone:229-485-7941
Mailing Address - Fax:
Practice Address - Street 1:3745 CHEROKEE ST NW STE 602
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-6785
Practice Address - Country:US
Practice Address - Phone:770-558-5491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-08
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT007551225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist