Provider Demographics
NPI:1699364794
Name:ABDULAZIZ, RACHEL CAROLINE (LMSW)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:CAROLINE
Last Name:ABDULAZIZ
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11309 W GRANT ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67209-3225
Mailing Address - Country:US
Mailing Address - Phone:316-992-9844
Mailing Address - Fax:
Practice Address - Street 1:11309 W GRANT ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67209-3225
Practice Address - Country:US
Practice Address - Phone:316-992-9844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-13
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS103711041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool