Provider Demographics
NPI:1649763335
Name:STOCK, RACHELLE (LAC)
Entity Type:Individual
Prefix:
First Name:RACHELLE
Middle Name:
Last Name:STOCK
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7329 E 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-3401
Mailing Address - Country:US
Mailing Address - Phone:602-750-6613
Mailing Address - Fax:
Practice Address - Street 1:7329 E 6TH AVE
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-3401
Practice Address - Country:US
Practice Address - Phone:602-750-6613
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-07
Last Update Date:2018-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0868171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist