MEDICARE: RACHEL LAURA RICHMOND SLP

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		MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7101002902	OTHER	MI	STATE LICENSE

General Provider Information

NPI Number	:	1851788442
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL LAURA RICHMOND SLP

Provider Business Mailing Address
First Line	:	9250 WALNUT DR
Second Line	:
City	:	TIPTON
State	:	MI
Zip	:	49287-9821
Country	:	US
Telephone Number	:	734-645-9084
Fax Number	:

Provider Business Practice Location Address
First Line	:	1424 S MAIN ST
Second Line	:
City	:	ADRIAN
State	:	MI
Zip	:	49221-4309
Country	:	US
Telephone Number	:	517-312-1712
Fax Number	:

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

Provider Enumeration Date	:	04/21/2015
Last Update Date	:	10/19/2020

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Directions to “ RACHEL LAURA RICHMOND SLP” Practice Location

Language	Start Address	Practice Location

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