Provider Demographics
NPI:1801383740
Name:SHOWALTER, RACHEL M (RBT)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:M
Last Name:SHOWALTER
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 OVERLOOK PASS
Mailing Address - Street 2:
Mailing Address - City:ENTERPRISE
Mailing Address - State:AL
Mailing Address - Zip Code:36330-8550
Mailing Address - Country:US
Mailing Address - Phone:334-806-7206
Mailing Address - Fax:
Practice Address - Street 1:807 DONNELL BLVD STE Q
Practice Address - Street 2:
Practice Address - City:DALEVILLE
Practice Address - State:AL
Practice Address - Zip Code:36322-2111
Practice Address - Country:US
Practice Address - Phone:334-709-4386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-17
Last Update Date:2018-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALRBT-16-16216106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician