Provider Demographics
NPI:1811240609
Name:PECK, RACHEL (OTR)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:PECK
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:HARVEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:176 AMERICAN WAY
Mailing Address - Street 2:
Mailing Address - City:BRANSON
Mailing Address - State:MO
Mailing Address - Zip Code:65616-9117
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11506 NICHOLAS ST
Practice Address - Street 2:STE 110
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-4407
Practice Address - Country:US
Practice Address - Phone:877-230-3885
Practice Address - Fax:402-505-9753
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-18
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00004482225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist