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General NPI Number Information
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NPI Number | 1902216997
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Entity Type | Individual
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Provider Name | RACHEL E JADKOWSKI PSYD
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Gender | Female
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Dates
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Enumeration Date | 04/30/2014
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Last Update Date | 07/06/2023
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Provider Practice Location Address
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Address Line | 117A W MAIN ST
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City | RICHMOND
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State | VT
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Zip | 05477-4451
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Country | US
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Telephone | 503-476-2528
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1158
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City | RICHMOND
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State | VT
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Zip | 05477-1158
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Country | US
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Telephone | 503-476-2528
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 048.0100344
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License Number State | VT
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