Provider Demographics
NPI:1558249904
Name:KIERNAN, RACHEL (COTA)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:KIERNAN
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:HOURIGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:612 LOVEGROVE AVE
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23323-4206
Mailing Address - Country:US
Mailing Address - Phone:203-631-9635
Mailing Address - Fax:
Practice Address - Street 1:776 OAK GROVE RD
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-3728
Practice Address - Country:US
Practice Address - Phone:757-389-7900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0131002821224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant