Provider Demographics
NPI:1124897673
Name:JOE, RACHEL ANNA
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:ANNA
Last Name:JOE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 WOODLAND DR
Mailing Address - Street 2:
Mailing Address - City:COLONIA
Mailing Address - State:NJ
Mailing Address - Zip Code:07067-3038
Mailing Address - Country:US
Mailing Address - Phone:732-675-1176
Mailing Address - Fax:
Practice Address - Street 1:57 UNION PL
Practice Address - Street 2:
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-2568
Practice Address - Country:US
Practice Address - Phone:908-273-5587
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-26
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
46TR01084600225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist