Provider Demographics
NPI:1639595887
Name:RACHAL, ASHLEY (RD, LDN)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:RACHAL
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:670 ALBEMARLE DR STE 700
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71106-5946
Mailing Address - Country:US
Mailing Address - Phone:318-532-4700
Mailing Address - Fax:318-209-3417
Practice Address - Street 1:670 ALBEMARLE DR STE 700
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71106-5946
Practice Address - Country:US
Practice Address - Phone:318-532-4700
Practice Address - Fax:318-209-3417
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-12
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1964133V00000X
TXDT86634133V00000X
LA2436133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty