Healthcare Provider Details

I. General information

NPI: 1942146790
Provider Name (Legal Business Name): RACHEL WHITE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2026
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 HERITAGE LNDG STE 109
SAINT PETERS MO
63303-8490
US

IV. Provider business mailing address

1600 HERITAGE LNDG STE 109
SAINT PETERS MO
63303-8490
US

V. Phone/Fax

Practice location:
  • Phone: 314-735-0099
  • Fax:
Mailing address:
  • Phone: 314-735-0099
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number2025012204
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: