Provider Demographics
NPI:1841787280
Name:BIGARD, RACHELLE ALICE (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:RACHELLE
Middle Name:ALICE
Last Name:BIGARD
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:MISS
Other - First Name:RACHELLE
Other - Middle Name:ALICE
Other - Last Name:LEIDING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:PO BOX 3178
Mailing Address - Street 2:
Mailing Address - City:HAYDEN
Mailing Address - State:ID
Mailing Address - Zip Code:83835-3178
Mailing Address - Country:US
Mailing Address - Phone:530-737-7361
Mailing Address - Fax:
Practice Address - Street 1:900 PALM ST
Practice Address - Street 2:
Practice Address - City:RED BLUFF
Practice Address - State:CA
Practice Address - Zip Code:96080-2626
Practice Address - Country:US
Practice Address - Phone:530-737-7361
Practice Address - Fax:530-529-4134
Is Sole Proprietor?:No
Enumeration Date:2018-04-20
Last Update Date:2018-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22006235Z00000X
ID3327235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist