MEDICARE: JULIE RAHN

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	3777	OK

General Provider Information

NPI Number	:	1710245915
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE RAHN

Provider Business Mailing Address
First Line	:	836 NW 37TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73118-7131
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	836 NW 37TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73118-7131
Country	:	US
Telephone Number	:	417-894-7939
Fax Number	:

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

Provider Enumeration Date	:	04/25/2012
Last Update Date	:	06/12/2012

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Directions to “ JULIE RAHN ” Practice Location

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