Provider Demographics
NPI:1609545250
Name:BOSSI, RACHEL ANN (MSOT, OTR/L)
Entity type:Individual
Prefix:MISS
First Name:RACHEL
Middle Name:ANN
Last Name:BOSSI
Suffix:
Gender:F
Credentials:MSOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 ANDOVER RD
Mailing Address - Street 2:
Mailing Address - City:WESTBROOK
Mailing Address - State:ME
Mailing Address - Zip Code:04092-3850
Mailing Address - Country:US
Mailing Address - Phone:207-761-2200
Mailing Address - Fax:
Practice Address - Street 1:123 ANDOVER RD
Practice Address - Street 2:
Practice Address - City:WESTBROOK
Practice Address - State:ME
Practice Address - Zip Code:04092-3850
Practice Address - Country:US
Practice Address - Phone:207-761-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-08
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT4147225XP0200X, 225XM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XM0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistMental Health
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEOT4147OtherSTATE OF MAINE BOARD OF OCCUPATIONAL THERAPY PRACTICE
458092OtherNATIONAL BOARD FOR CERTIFICATION IN OCCUPATIONAL THERAPY