MEDICARE: RACHEL KNUDSON

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	7429-226	WI

General Provider Information

NPI Number	:	1922792985
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL KNUDSON

Provider Business Mailing Address
First Line	:	2602 HILS CT
Second Line	:
City	:	MENOMONIE
State	:	WI
Zip	:	54751-1125
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2602 HILS CT
Second Line	:
City	:	MENOMONIE
State	:	WI
Zip	:	54751-1125
Country	:	US
Telephone Number	:	715-246-4840
Fax Number	:

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

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

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Directions to “ RACHEL KNUDSON ” Practice Location

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