MEDICARE: RACHELLE BELOTT

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	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1063977882
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHELLE BELOTT

Provider Business Mailing Address
First Line	:	5509 WINDING CREEK DR
Second Line	:
City	:	WESTON
State	:	WI
Zip	:	54476-6653
Country	:	US
Telephone Number	:	715-571-5713
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 N 3RD ST STE 208-3&4
Second Line	:
City	:	WAUSAU
State	:	WI
Zip	:	54403-4885
Country	:	US
Telephone Number	:	715-370-8863
Fax Number	:

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

Provider Enumeration Date	:	02/06/2019
Last Update Date	:	02/06/2019

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Directions to “ RACHELLE BELOTT ” Practice Location

Language	Start Address	Practice Location

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