Provider Demographics
NPI:1164565792
Name:WAITE, RACHEL A (MS, CCC-A)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:A
Last Name:WAITE
Suffix:
Gender:F
Credentials:MS, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3317 S HOLBROOK LN
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-5963
Mailing Address - Country:US
Mailing Address - Phone:480-839-4924
Mailing Address - Fax:
Practice Address - Street 1:3317 S HOLBROOK LN
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-5963
Practice Address - Country:US
Practice Address - Phone:480-839-4924
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDA1773231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist