Doctor Name: | MS. RACHEL M BOURGAULT |
NPI Number: | 1386815066 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 103 |
Business Practice Address: | 2186 Highway 14 Banner, WY - 828329709 |
Business Phone Number: | 3077372274 |
Business Fax Number: | |
Mailing Address: | 2186 Highway 14, BANNER |
State: | WY |
Postal Code: | 828329709 |
Phone Number: | 3077372274 |
Fax Number: | |
NPI Enumeration Date: | 03/20/2008 |
NPI Last Update Date: | 03/20/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 103 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WY |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |