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General NPI Number Information
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NPI Number | 1598589681
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Entity Type | Organization
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Legal Business Name | RACHEL CHICKERELLA'S PRIVATE PRACTICE
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Dates
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Enumeration Date | 11/14/2024
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Last Update Date | 11/14/2024
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Provider Practice Location Address
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Address Line | 40 AVON ST
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City | KEENE
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State | NH
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Zip | 03431-3516
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Country | US
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Telephone | 802-416-0980
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Fax |
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Provider Business Mailing Address
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Address Line | 19 HILLSIDE AVE
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City | KEENE
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State | NH
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Zip | 03431-4360
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Country | US
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Telephone | 614-309-5705
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RACHEL CHICKERELLA
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Credential | PHD
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Telephone | 802-416-0980
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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