Provider Demographics
NPI:1548570229
Name:MCLAIN, RACHEL ROSEMARY (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:ROSEMARY
Last Name:MCLAIN
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:MS
Other - First Name:RACHEL
Other - Middle Name:ROSEMARY
Other - Last Name:LANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:715 LINCOLN AVE NW
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49504-4043
Mailing Address - Country:US
Mailing Address - Phone:616-901-0961
Mailing Address - Fax:
Practice Address - Street 1:715 LINCOLN AVE NW
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49504-4043
Practice Address - Country:US
Practice Address - Phone:616-901-0961
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-15
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI12095894235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist