Provider Demographics
NPI:1285348821
Name:POPP, RACHAEL
Entity type:Individual
Prefix:
First Name:RACHAEL
Middle Name:
Last Name:POPP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RACHAEL
Other - Middle Name:
Other - Last Name:MCDONALD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:109 WIND HAVEN DR STE 100
Mailing Address - Street 2:
Mailing Address - City:NICHOLASVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40356-8010
Mailing Address - Country:US
Mailing Address - Phone:859-224-2273
Mailing Address - Fax:859-224-4675
Practice Address - Street 1:3499 BLAZER PKWY STE 170
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-2823
Practice Address - Country:US
Practice Address - Phone:859-224-2273
Practice Address - Fax:859-224-4675
Is Sole Proprietor?:No
Enumeration Date:2023-01-09
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY282703225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist