Healthcare Provider Details

I. General information

NPI: 1518525237
Provider Name (Legal Business Name): RACHEL KELLY MADOR-HOUSE CGC, M.SC., MSC.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2019
Last Update Date: 05/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

685 & 695 S DOBSON RD
CHANDLER AZ
85224
US

IV. Provider business mailing address

PO BOX 6423
CHANDLER AZ
85246-6423
US

V. Phone/Fax

Practice location:
  • Phone: 480-821-2838
  • Fax: 480-398-8080
Mailing address:
  • Phone: 480-855-2224
  • Fax: 480-398-8080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: