Provider Demographics
NPI:1619726536
Name:CARLSON, RACHEL BARHAM (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:BARHAM
Last Name:CARLSON
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8078B YARBROUGH ST
Mailing Address - Street 2:
Mailing Address - City:DEL RIO
Mailing Address - State:TX
Mailing Address - Zip Code:78840-2759
Mailing Address - Country:US
Mailing Address - Phone:772-834-7525
Mailing Address - Fax:
Practice Address - Street 1:707 E 17TH ST STE B
Practice Address - Street 2:
Practice Address - City:DEL RIO
Practice Address - State:TX
Practice Address - Zip Code:78840-7864
Practice Address - Country:US
Practice Address - Phone:830-313-7070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-14
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX124563225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist