MEDICARE: RACHEL ALEXA BRESALIER

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	235Z00000X	Speech-Language Pathologist	PSL002089	PA

General Provider Information

NPI Number	:	1588358592
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL ALEXA BRESALIER

Provider Business Mailing Address
First Line	:	1815 JFK BLVD APT 2714
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-1724
Country	:	US
Telephone Number	:	856-313-0408
Fax Number	:

Provider Business Practice Location Address
First Line	:	1815 JFK BLVD APT 2714
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-1724
Country	:	US
Telephone Number	:	856-313-0408
Fax Number	:

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

Provider Enumeration Date	:	06/05/2023
Last Update Date	:	06/05/2023

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Directions to “ RACHEL ALEXA BRESALIER ” Practice Location

Language	Start Address	Practice Location

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