Provider Demographics
NPI:1669653010
Name:RECHAVEL, ESTHER MINDY
Entity Type:Individual
Prefix:MRS
First Name:ESTHER
Middle Name:MINDY
Last Name:RECHAVEL
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:ESSIE
Other - Middle Name:
Other - Last Name:RECHAVEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS/CCC-SLP
Mailing Address - Street 1:3024 W ROCHELLE AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:WI
Mailing Address - Zip Code:53209-2502
Mailing Address - Country:US
Mailing Address - Phone:414-352-7704
Mailing Address - Fax:
Practice Address - Street 1:316 N MILWAUKEE ST
Practice Address - Street 2:SUITE 208
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-5885
Practice Address - Country:US
Practice Address - Phone:414-615-0665
Practice Address - Fax:888-389-9031
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-14
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI175154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI175154OtherSTATE LICENSE