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NPI Code Detail

MEDICARE: EMILY RACHELLE TIMES LCSW

MEDICARE: EMILY RACHELLE TIMES LCSW
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
11041C0700XClinical Social Worker69435TX

General Provider Information

NPI Number : 1669150041
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY RACHELLE TIMES LCSW
Provider Business Mailing Address
First Line : PO BOX 890
Second Line :
City : WACO
State : TX
Zip : 76703-0890
Country : US
Telephone Number : 254-752-3451
Fax Number :
Provider Business Practice Location Address
First Line : 2800 LYLE AVE
Second Line :
City : WACO
State : TX
Zip : 76708-2680
Country : US
Telephone Number : 254-297-7100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2023
Last Update Date : 07/06/2023

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Directions to “ EMILY RACHELLE TIMES LCSW” Practice Location

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