Healthcare Provider Details

I. General information

NPI: 1740328384
Provider Name (Legal Business Name): MRS. RACHEL LYNN STOTTS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS RACHEL LYNN REESE

II. Dates (important events)

Enumeration Date: 02/04/2007
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1104 7TH AVE S
MOORHEAD MN
56563-0001
US

IV. Provider business mailing address

2883 26TH STREET CIR S
MOORHEAD MN
56560-5353
US

V. Phone/Fax

Practice location:
  • Phone: 218-477-2286
  • Fax: 218-477-4392
Mailing address:
  • Phone: 218-287-1184
  • Fax: 701-232-2330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number966
License Number StateND
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number8118
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: