Provider Demographics
NPI:1144519786
Name:MARTIN, RACHAEL S (MS, RD, LD)
Entity type:Individual
Prefix:
First Name:RACHAEL
Middle Name:S
Last Name:MARTIN
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 PEARSON DR SW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35802-1744
Mailing Address - Country:US
Mailing Address - Phone:256-426-6884
Mailing Address - Fax:
Practice Address - Street 1:506 PEARSON DR SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35802-1744
Practice Address - Country:US
Practice Address - Phone:256-426-6884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-05
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2059133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered