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General NPI Number Information
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NPI Number | 1497136303
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Entity Type | Individual
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Provider Name | RACHEL MICHELLE WALTRIP LPC
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Gender | Female
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Dates
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Enumeration Date | 06/16/2015
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Last Update Date | 06/21/2021
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Provider Practice Location Address
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Address Line | 6161 S YALE AVE
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City | TULSA
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State | OK
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Zip | 74136-1902
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Country | US
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Telephone | 918-502-0856
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Fax | 918-501-0211
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Provider Business Mailing Address
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Address Line | 6161 S YALE AVE
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City | TULSA
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State | OK
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Zip | 74136-1902
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Country | US
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Telephone | 918-240-5452
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 10100
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License Number State | OK
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