Provider Demographics
NPI:1992284749
Name:BABYAK, RACHEL REBECCA (COTA)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:REBECCA
Last Name:BABYAK
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5026 CLOUDBURST HL
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-1501
Mailing Address - Country:US
Mailing Address - Phone:509-499-1109
Mailing Address - Fax:
Practice Address - Street 1:5026 CLOUDBURST HL
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-1501
Practice Address - Country:US
Practice Address - Phone:509-499-1109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-13
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
A02475224Z00000X
MDA02475224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant