Provider Demographics
NPI:1083127070
Name:PENTLAND, RACHEL (MA)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:PENTLAND
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2109 S HIGHWAY 69
Mailing Address - Street 2:
Mailing Address - City:WAGONER
Mailing Address - State:OK
Mailing Address - Zip Code:74467-9310
Mailing Address - Country:US
Mailing Address - Phone:918-708-3006
Mailing Address - Fax:918-777-9016
Practice Address - Street 1:2109 S HIGHWAY 69
Practice Address - Street 2:
Practice Address - City:WAGONER
Practice Address - State:OK
Practice Address - Zip Code:74467-9310
Practice Address - Country:US
Practice Address - Phone:918-708-3006
Practice Address - Fax:918-777-9016
Is Sole Proprietor?:No
Enumeration Date:2017-11-13
Last Update Date:2017-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health