Provider Demographics
NPI:1568637619
Name:GUSE, RACHELLE RAE (MASTERS)
Entity Type:Individual
Prefix:MRS
First Name:RACHELLE
Middle Name:RAE
Last Name:GUSE
Suffix:
Gender:F
Credentials:MASTERS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N5589 COMMERCE RD
Mailing Address - Street 2:SUITE 170A
Mailing Address - City:ONALASKA
Mailing Address - State:WI
Mailing Address - Zip Code:54650-9266
Mailing Address - Country:US
Mailing Address - Phone:507-474-0966
Mailing Address - Fax:
Practice Address - Street 1:N5589 COMMERCE RD
Practice Address - Street 2:SUITE 170A
Practice Address - City:ONALASKA
Practice Address - State:WI
Practice Address - Zip Code:54650-9266
Practice Address - Country:US
Practice Address - Phone:507-474-0966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WIIN PROCESS106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist