Provider Demographics
NPI:1841664133
Name:GRIFFIN, RACHEL ANNE (OTD)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:ANNE
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 MCGEE DR STE 113
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-5858
Mailing Address - Country:US
Mailing Address - Phone:720-299-6289
Mailing Address - Fax:
Practice Address - Street 1:1300 MCGEE DR STE 113
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072
Practice Address - Country:US
Practice Address - Phone:720-299-6289
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-24
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
247200000X
OK5268225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK5268OtherOKLAHOMA STATE BOARD OF MEDICAL LICENSURE AND SUPERVISION
346176OtherNATIONAL BOARD OF CERTIFICATION IN OCCUPATIONAL THERAPY