Provider Demographics
NPI:1558780437
Name:FANCHER, RACHEL MARIE
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:MARIE
Last Name:FANCHER
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 1:5219 MAPLE AVE
Mailing Address - Street 2:APT 1105
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-7433
Mailing Address - Country:US
Mailing Address - Phone:404-520-7206
Mailing Address - Fax:
Practice Address - Street 1:5219 MAPLE AVE
Practice Address - Street 2:APT 1105
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-7433
Practice Address - Country:US
Practice Address - Phone:404-520-7206
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-08
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist