Provider Demographics
NPI:1528504487
Name:LOCKE, RACHEL (OTR/L)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:LOCKE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:GABRIEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:PO BOX 31630
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85751-1630
Mailing Address - Country:US
Mailing Address - Phone:520-784-6200
Mailing Address - Fax:520-784-6109
Practice Address - Street 1:3988 E FORT LOWELL RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-1010
Practice Address - Country:US
Practice Address - Phone:520-488-5291
Practice Address - Fax:520-689-6810
Is Sole Proprietor?:No
Enumeration Date:2017-01-16
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6211225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ238728Medicaid