Provider Demographics
NPI:1528490174
Name:BROWN, RACHEL NICOLE (COTA/L)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:NICOLE
Last Name:BROWN
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:533 CALVIN ST
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:TN
Mailing Address - Zip Code:37763-3524
Mailing Address - Country:US
Mailing Address - Phone:865-376-1036
Mailing Address - Fax:
Practice Address - Street 1:120 CAVETTE HILL LN
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-6673
Practice Address - Country:US
Practice Address - Phone:865-777-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-06
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2263224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant