Provider Demographics
NPI:1770702326
Name:CHANEY, RACHEL
Entity type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:
Last Name:CHANEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 W MAIN ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ARDMORE
Mailing Address - State:OK
Mailing Address - Zip Code:73401-6505
Mailing Address - Country:US
Mailing Address - Phone:580-223-3383
Mailing Address - Fax:580-223-6696
Practice Address - Street 1:2 W MAIN ST
Practice Address - Street 2:SUITE 200
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-6505
Practice Address - Country:US
Practice Address - Phone:580-223-3383
Practice Address - Fax:580-223-6696
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3129235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist