Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 5238 | SC |
N | 225X00000X | Occupational Therapist | OT006568 | GA |
NPI | 1003366998 |
---|---|
Provider Name | Miss Rachel Helen Cousar |
First Address | Gainesville, GA 30504-5107 |
Second Address | Mt Pleasant, SC 29464-5431 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2016 |
Last Update Date | 16/07/2020 |