Provider Demographics
NPI:1013486513
Name:MCKELL, RACHEL CHRISTINE (CCC-SLP)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:CHRISTINE
Last Name:MCKELL
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7545 OSO BLANCA RD UNIT 4206
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89149-1511
Mailing Address - Country:US
Mailing Address - Phone:559-801-3116
Mailing Address - Fax:
Practice Address - Street 1:8020 W SAHARA AVE STE 160
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-7917
Practice Address - Country:US
Practice Address - Phone:702-595-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-14
Last Update Date:2020-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
14107015OtherAMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION
IDSLP-3746OtherSTATE OF IDAHO
NVSP-2695OtherNEVADA SLP STATE LICENSE