Provider Demographics
NPI:1568812154
Name:ALLEN, RACHELLE NACOLE (MS, CF-SLP)
Entity Type:Individual
Prefix:MRS
First Name:RACHELLE
Middle Name:NACOLE
Last Name:ALLEN
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:RACHELLE
Other - Middle Name:NACOLE
Other - Last Name:PHILLIPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 892373
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73189
Mailing Address - Country:US
Mailing Address - Phone:405-601-4303
Mailing Address - Fax:405-703-9144
Practice Address - Street 1:400 N EASTERN AVE
Practice Address - Street 2:
Practice Address - City:MOORE
Practice Address - State:OK
Practice Address - Zip Code:73160-5833
Practice Address - Country:US
Practice Address - Phone:405-601-4303
Practice Address - Fax:405-703-9144
Is Sole Proprietor?:No
Enumeration Date:2016-06-15
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist