Provider Demographics
NPI:1023382082
Name:NORMAN, RACHELLE (MT-BC)
Entity Type:Individual
Prefix:
First Name:RACHELLE
Middle Name:
Last Name:NORMAN
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8512 N WAYLAND AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64153-1695
Mailing Address - Country:US
Mailing Address - Phone:913-548-7169
Mailing Address - Fax:
Practice Address - Street 1:8512 N WAYLAND AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64153-1695
Practice Address - Country:US
Practice Address - Phone:913-548-7169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-07
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist