Provider Demographics
NPI:1164048773
Name:TRIPLETT, RACHEL C (SLP-T)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:C
Last Name:TRIPLETT
Suffix:
Gender:F
Credentials:SLP-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 SW EAGLES PKWY STE 210
Mailing Address - Street 2:
Mailing Address - City:GRAIN VALLEY
Mailing Address - State:MO
Mailing Address - Zip Code:64029-8512
Mailing Address - Country:US
Mailing Address - Phone:816-265-1170
Mailing Address - Fax:
Practice Address - Street 1:105 SW EAGLES PKWY STE 210
Practice Address - Street 2:
Practice Address - City:GRAIN VALLEY
Practice Address - State:MO
Practice Address - Zip Code:64029-8512
Practice Address - Country:US
Practice Address - Phone:816-265-1170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-19
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
KS3558235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician