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NPI 1679959522

NPI 1679959522 : RACHEL REID M.A. : COEUR D ALENE, ID

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General NPI Number Information
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    NPI Number           |    1679959522
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    Entity Type          |    Individual 
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    Provider Name        |    RACHEL REID M.A.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/03/2015
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    Last Update Date     |    09/16/2020
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Provider Practice Location Address
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    Address Line         |    410 E SHERMAN AVE STE 201 
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    City                 |    COEUR D ALENE
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    State                |    ID
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    Zip                  |    83814-2761
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    Country              |    US
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    Telephone            |    208-661-4667
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    410 E SHERMAN AVE STE 201 
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    City                 |    COEUR D ALENE
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    State                |    ID
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    Zip                  |    83814-2761
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    Country              |    US
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    Telephone            |    208-661-4667
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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        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    LH60799069
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    License Number State |    WA
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Taxonomy #2
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    Taxonomy Code        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    MC60673276
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    License Number State |    WA
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Taxonomy #3
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    Taxonomy Code        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    LPC-7639
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    License Number State |    ID
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