Provider Demographics
NPI:1790749265
Name:STEBE, RACHELLE LANEA (ATC)
Entity Type:Individual
Prefix:MS
First Name:RACHELLE
Middle Name:LANEA
Last Name:STEBE
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:MS
Other - First Name:RACHELLE
Other - Middle Name:LANEA
Other - Last Name:VARBLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC
Mailing Address - Street 1:112 PHYLLISAIRE CT
Mailing Address - Street 2:
Mailing Address - City:ST PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-6553
Mailing Address - Country:US
Mailing Address - Phone:636-577-3936
Mailing Address - Fax:
Practice Address - Street 1:221 SPENCER RD
Practice Address - Street 2:SUITE D
Practice Address - City:ST PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-2438
Practice Address - Country:US
Practice Address - Phone:636-477-9911
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20050240992255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer