Provider Demographics
NPI:1801347737
Name:FIELDHOUSE, EVE RACHEL HAY (MA, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:EVE
Middle Name:RACHEL HAY
Last Name:FIELDHOUSE
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 WINDSHIP DR
Mailing Address - Street 2:
Mailing Address - City:PORT TOWNSEND
Mailing Address - State:WA
Mailing Address - Zip Code:98368-9545
Mailing Address - Country:US
Mailing Address - Phone:907-321-2003
Mailing Address - Fax:
Practice Address - Street 1:2001 N DUSTIN AVE
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87401-2120
Practice Address - Country:US
Practice Address - Phone:505-324-9840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-15
Last Update Date:2016-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM376348235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist