Provider Demographics
NPI:1043033178
Name:MCCRACKEN, RACHAEL MARIE (OTR/L)
Entity type:Individual
Prefix:
First Name:RACHAEL
Middle Name:MARIE
Last Name:MCCRACKEN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY HILLS
Mailing Address - State:MA
Mailing Address - Zip Code:02481-2117
Mailing Address - Country:US
Mailing Address - Phone:781-239-0100
Mailing Address - Fax:
Practice Address - Street 1:10 TECH CIR
Practice Address - Street 2:
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-1029
Practice Address - Country:US
Practice Address - Phone:781-239-0100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA15202225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist