Individual
RACHEL FORTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
127 E STATE ST, GLOVERSVILLE, NY 12078-1204
(518) 773-7931
Mailing address
127 E STATE ST, GLOVERSVILLE, NY 12078-1204
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
010257-01
NY
224Z00000X
Occupational Therapy Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010257
—
NY
Enumeration date
02/06/2020
Last updated
01/14/2022
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