Provider Demographics
NPI:1093438392
Name:HECKROTH, RACHEL (CO61535441)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:HECKROTH
Suffix:
Gender:F
Credentials:CO61535441
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:232 2ND AVE S
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98032-5862
Mailing Address - Country:US
Mailing Address - Phone:253-859-0300
Mailing Address - Fax:
Practice Address - Street 1:232 2ND AVE S
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98032-5862
Practice Address - Country:US
Practice Address - Phone:253-859-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-21
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health