Provider Demographics
NPI:1407626054
Name:DAVIDHIZAR, RACHELLE RENEE (MSW)
Entity Type:Individual
Prefix:
First Name:RACHELLE
Middle Name:RENEE
Last Name:DAVIDHIZAR
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1642 MCCULLOCH BLVD N # 463
Mailing Address - Street 2:
Mailing Address - City:LAKE HAVASU CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86403-0961
Mailing Address - Country:US
Mailing Address - Phone:928-733-8681
Mailing Address - Fax:
Practice Address - Street 1:3027 ARABIAN DRIVE
Practice Address - Street 2:
Practice Address - City:LAKE HAVASU CITY
Practice Address - State:AZ
Practice Address - Zip Code:86404
Practice Address - Country:US
Practice Address - Phone:928-733-8681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-04
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker