Provider Demographics
NPI:1952610545
Name:TOMBAUGH, RACHEL MICHELE (MA, LPC)
Entity Type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:MICHELE
Last Name:TOMBAUGH
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
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Mailing Address - Street 1:38031 N 21ST AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-8377
Mailing Address - Country:US
Mailing Address - Phone:602-446-2222
Mailing Address - Fax:602-346-0117
Practice Address - Street 1:4150 W PEORIA AVE
Practice Address - Street 2:SUITE 133
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029-3900
Practice Address - Country:US
Practice Address - Phone:602-446-2222
Practice Address - Fax:602-346-0117
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-29
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ13724101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional