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General NPI Number Information
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NPI Number | 1790200145
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Entity Type | Individual
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Provider Name | RACHEL PADDOCK
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Gender | Female
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Dates
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Enumeration Date | 08/07/2017
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Last Update Date | 08/07/2017
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Provider Practice Location Address
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Address Line | 460 MCMENAMY RD
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City | SAINT PETERS
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State | MO
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Zip | 63376-1510
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Country | US
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Telephone | 636-397-3111
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Fax |
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Provider Business Mailing Address
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Address Line | 2913 MIDDLEBUSH CT
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City | SAINT LOUIS
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State | MO
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Zip | 63119-1429
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Country | US
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Telephone |
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 2017025394
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State | MO
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