Individual
RACHELLE M HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COMS
Contact information
Practice address
1 FREEDOM WAY, AUGUSTA, GA 30904-6258
(706) 733-0188
Mailing address
1 FREEDOM WAY, AUGUSTA, GA 30904-6258
(706) 733-0188
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
5154
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5154
ACVREP
—
Enumeration date
12/14/2012
Last updated
12/14/2012
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