Provider Demographics
NPI:1053895755
Name:JEFFERIES, RACHEL ANN ISABEL
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:ANN ISABEL
Last Name:JEFFERIES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HUMMINGBIRD LN
Mailing Address - Street 2:
Mailing Address - City:MATTAPAN
Mailing Address - State:MA
Mailing Address - Zip Code:02126-1993
Mailing Address - Country:US
Mailing Address - Phone:708-916-5053
Mailing Address - Fax:
Practice Address - Street 1:695 TRUMAN HWY STE 201
Practice Address - Street 2:
Practice Address - City:HYDE PARK
Practice Address - State:MA
Practice Address - Zip Code:02136-3552
Practice Address - Country:US
Practice Address - Phone:857-345-9474
Practice Address - Fax:877-243-2959
Is Sole Proprietor?:No
Enumeration Date:2018-09-18
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist