Healthcare Provider Details

I. General information

NPI: 1598146599
Provider Name (Legal Business Name): RACHEL SCHILLING M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2015
Last Update Date: 06/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1137 MOUNTAIN LAUREL WAY
LEXINGTON KY
40511-8654
US

IV. Provider business mailing address

1137 MOUNTAIN LAUREL WAY
LEXINGTON KY
40511-8654
US

V. Phone/Fax

Practice location:
  • Phone: 859-394-4135
  • Fax:
Mailing address:
  • Phone: 859-394-4135
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number201132729
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: