Provider Demographics
NPI:1972974723
Name:OTTO-THORPE, RACHEL MARIE (AUD)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:MARIE
Last Name:OTTO-THORPE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:MARIE
Other - Last Name:OTTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:675 W LUMSDEN RD
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-5911
Mailing Address - Country:US
Mailing Address - Phone:813-643-1652
Mailing Address - Fax:813-643-1786
Practice Address - Street 1:675 W LUMSDEN RD
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5911
Practice Address - Country:US
Practice Address - Phone:813-643-1652
Practice Address - Fax:813-643-1786
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-19
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist