Provider Demographics
NPI:1245994250
Name:JEAN-PAUL, RACHELLE (ND, LAC)
Entity type:Individual
Prefix:
First Name:RACHELLE
Middle Name:
Last Name:JEAN-PAUL
Suffix:
Gender:F
Credentials:ND, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 UNION AVE APT 32
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-3733
Mailing Address - Country:US
Mailing Address - Phone:203-722-1560
Mailing Address - Fax:
Practice Address - Street 1:1901 S 9TH ST STE 508
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19148-2391
Practice Address - Country:US
Practice Address - Phone:267-223-5275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-26
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAK001376171100000X
CT5.000701175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty