Provider Demographics
NPI:1629442751
Name:WETTERAUER, RACHEL LEIGH (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:LEIGH
Last Name:WETTERAUER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 DONIPHAN DR APT 5
Mailing Address - Street 2:
Mailing Address - City:FORT LEAVENWORTH
Mailing Address - State:KS
Mailing Address - Zip Code:66027-1380
Mailing Address - Country:US
Mailing Address - Phone:573-452-1563
Mailing Address - Fax:
Practice Address - Street 1:210 E MARY ST
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:KS
Practice Address - Zip Code:66043-1633
Practice Address - Country:US
Practice Address - Phone:913-250-1115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-01
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS3833235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist