MEDICARE: RACHEL WALTON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1417507310
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL WALTON

Provider Business Mailing Address
First Line	:	1059 COLLINWOOD HWY
Second Line	:
City	:	WAYNESBORO
State	:	TN
Zip	:	38485-3801
Country	:	US
Telephone Number	:	601-754-5561
Fax Number	:

Provider Business Practice Location Address
First Line	:	950 ANDREW JACKSON DRIVE
Second Line	:
City	:	WAYNESBORO
State	:	TN
Zip	:	38485-3848
Country	:	US
Telephone Number	:	931-253-2140
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2019
Last Update Date	:	09/13/2019

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Directions to “ RACHEL WALTON ” Practice Location

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