Provider Demographics
NPI:1811199425
Name:VON ESCHENBACH, RACHAEL JEAN (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:JEAN
Last Name:VON ESCHENBACH
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1303 LORRAIN ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78703-4020
Mailing Address - Country:US
Mailing Address - Phone:512-472-6080
Mailing Address - Fax:
Practice Address - Street 1:1303 LORRAIN ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78703-4020
Practice Address - Country:US
Practice Address - Phone:512-472-6080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17137235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist