Provider Demographics
NPI:1134663271
Name:STOCKLE, RACHEL L (RD)
Entity type:Individual
Prefix:MISS
First Name:RACHEL
Middle Name:L
Last Name:STOCKLE
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8594 WRENFORD COURT
Mailing Address - Street 2:
Mailing Address - City:MACEDONIA
Mailing Address - State:OH
Mailing Address - Zip Code:44056
Mailing Address - Country:US
Mailing Address - Phone:216-215-5251
Mailing Address - Fax:
Practice Address - Street 1:8594 WRENFORD CT
Practice Address - Street 2:
Practice Address - City:MACEDONIA
Practice Address - State:OH
Practice Address - Zip Code:44056-1750
Practice Address - Country:US
Practice Address - Phone:216-215-5251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-08
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH86000917133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic