MEDICARE: RACHEL ASH LICSW

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	1041C0700X	Clinical Social Worker	18594	MN

General Provider Information

NPI Number	:	1548458979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL ASH LICSW

Provider Business Mailing Address
First Line	:	1523 HIGHWAY 13 E
Second Line	:
City	:	BURNSVILLE
State	:	MN
Zip	:	55337-2917
Country	:	US
Telephone Number	:	952-894-4828
Fax Number	:	507-387-6155

Provider Business Practice Location Address
First Line	:	1523 HIGHWAY 13 E
Second Line	:
City	:	BURNSVILLE
State	:	MN
Zip	:	55337-2917
Country	:	US
Telephone Number	:	952-894-4828
Fax Number	:	507-387-6155

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

Provider Enumeration Date	:	10/10/2007
Last Update Date	:	10/10/2007

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Directions to “ RACHEL ASH LICSW” Practice Location

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