Provider Demographics
NPI:1083268114
Name:WALSH, RACHEL J (CPM, LM)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:J
Last Name:WALSH
Suffix:
Gender:F
Credentials:CPM, LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4801 N PASEO SONOYTA
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85750-1619
Mailing Address - Country:US
Mailing Address - Phone:310-913-3176
Mailing Address - Fax:
Practice Address - Street 1:4801 N PASEO SONOYTA
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85750-1619
Practice Address - Country:US
Practice Address - Phone:310-913-3176
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-26
Last Update Date:2019-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLM224176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife