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General NPI Number Information
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NPI Number | 1013684646
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Entity Type | Individual
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Provider Name | RAECHAL BROOKS MCMILLAN AU.D
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Gender | Female
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Dates
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Enumeration Date | 08/23/2021
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Last Update Date | 12/28/2021
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Provider Practice Location Address
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Address Line | 710 S BROADWAY STE 220
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City | WALNUT CREEK
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State | CA
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Zip | 94596-5234
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Country | US
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Telephone | 925-295-6933
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Fax |
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Provider Business Mailing Address
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Address Line | 835 ARLINGTON CT
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City | RENO
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State | NV
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Zip | 89509-3200
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Country | US
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Telephone | 775-229-5435
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number |
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License Number State |
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