Provider Demographics
NPI:1053046219
Name:WINGFIELD, RACHEL A (PHD)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:A
Last Name:WINGFIELD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:A
Other - Last Name:SANDERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 251418
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72225-1418
Mailing Address - Country:US
Mailing Address - Phone:501-364-1100
Mailing Address - Fax:501-364-4082
Practice Address - Street 1:1 CHILDRENS WAY # 612
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72202-3500
Practice Address - Country:US
Practice Address - Phone:501-364-1830
Practice Address - Fax:501-978-6492
Is Sole Proprietor?:No
Enumeration Date:2022-07-21
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR202196103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist