Healthcare Provider Details

I. General information

NPI: 1245994250
Provider Name (Legal Business Name): RACHELLE JEAN-PAUL ND, L.AC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/26/2021
Last Update Date: 01/03/2022
Certification Date: 01/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 S 9TH ST STE 508
PHILADELPHIA PA
19148-2391
US

IV. Provider business mailing address

32 UNION AVE APT 32
NORWALK CT
06851-3733
US

V. Phone/Fax

Practice location:
  • Phone: 267-223-5275
  • Fax:
Mailing address:
  • Phone: 203-722-1560
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAK001376
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number5.000701
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: