MEDICARE: RACHAEL ANNE HARRELSON MS CCC-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
2	235Z00000X	Speech-Language Pathologist	114787	TX

General Provider Information

NPI Number	:	1972971190
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHAEL ANNE HARRELSON MS CCC-SLP

Provider Business Mailing Address
First Line	:	312 E RENFRO ST STE 107
Second Line	:
City	:	BURLESON
State	:	TX
Zip	:	76028-3948
Country	:	US
Telephone Number	:	817-239-2284
Fax Number	:	817-213-6243

Provider Business Practice Location Address
First Line	:	312 E RENFRO ST STE 107
Second Line	:
City	:	BURLESON
State	:	TX
Zip	:	76028-3948
Country	:	US
Telephone Number	:	817-239-2284
Fax Number	:	817-213-6243

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

Provider Enumeration Date	:	09/03/2015
Last Update Date	:	08/12/2025

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Directions to “ RACHAEL ANNE HARRELSON MS CCC-SLP” Practice Location

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