Provider Demographics
NPI:1235251547
Name:DALE, RACHEL ADELE (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:ADELE
Last Name:DALE
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6791 W STATE ROAD 124
Mailing Address - Street 2:
Mailing Address - City:WABASH
Mailing Address - State:IN
Mailing Address - Zip Code:46992-8899
Mailing Address - Country:US
Mailing Address - Phone:260-563-2787
Mailing Address - Fax:260-563-6972
Practice Address - Street 1:6791 W STATE ROAD 124
Practice Address - Street 2:
Practice Address - City:WABASH
Practice Address - State:IN
Practice Address - Zip Code:46992-8899
Practice Address - Country:US
Practice Address - Phone:260-563-2787
Practice Address - Fax:260-563-6972
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22004131A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist