MEDICARE: DR. RACHEL HUMMEL-SASS PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC2200X	Clinical Child & Adolescent Psychologist	7295	OH

General Provider Information

NPI Number	:	1003295627
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RACHEL HUMMEL-SASS PSY.D.

Provider Business Mailing Address
First Line	:	PO BOX 954
Second Line	:
City	:	TIFFIN
State	:	OH
Zip	:	44883-0954
Country	:	US
Telephone Number	:	419-455-6891
Fax Number	:	419-710-1738

Provider Business Practice Location Address
First Line	:	200 SAINT FRANCIS AVE
Second Line	:
City	:	TIFFIN
State	:	OH
Zip	:	44883-3458
Country	:	US
Telephone Number	:	419-455-6891
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/28/2015
Last Update Date	:	10/12/2021

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