Provider Demographics
NPI:1649096462
Name:SCHENCK, RACHEL LAUREN (RD, LD)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:LAUREN
Last Name:SCHENCK
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 BROOKSIDE AVE STE 180
Mailing Address - Street 2:
Mailing Address - City:AMBLER
Mailing Address - State:PA
Mailing Address - Zip Code:19002-3436
Mailing Address - Country:US
Mailing Address - Phone:484-416-4243
Mailing Address - Fax:
Practice Address - Street 1:2380 LAKE PARK RD APT 815
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40502-6601
Practice Address - Country:US
Practice Address - Phone:859-298-8395
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-26
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY295940133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered