Provider Demographics
NPI:1225518210
Name:PEPE, RACHEL VIOLA
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:VIOLA
Last Name:PEPE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1749 SPEEDWELL RD
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-4628
Mailing Address - Country:US
Mailing Address - Phone:717-392-5297
Mailing Address - Fax:
Practice Address - Street 1:120 FOXSHIRE DR
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-3982
Practice Address - Country:US
Practice Address - Phone:717-431-6615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-18
Last Update Date:2018-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW135377101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty