Provider Demographics
NPI:1538814397
Name:SIMEONE, RACHEL LYNN
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:LYNN
Last Name:SIMEONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2114 KENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23228-5213
Mailing Address - Country:US
Mailing Address - Phone:724-766-1229
Mailing Address - Fax:
Practice Address - Street 1:350 HIOAKS RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225-4018
Practice Address - Country:US
Practice Address - Phone:804-320-1412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-19
Last Update Date:2022-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305211368225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist