Basic Information
| Provider Information | |||||||||
| NPI: | 1740935196 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PURCEL | ||||||||
| FirstName: | RACHAEL | ||||||||
| MiddleName: | NICOLE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2627 N 3RD ST STE 201 | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850041194 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6023079919 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2627 N 3RD ST STE 201 | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850041194 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6023079919 | ||||||||
| FaxNumber: | 6023075905 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/15/2022 | ||||||||
| LastUpdateDate: | 02/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/21/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | Y | Speech, Language and Hearing Service Providers | Audiologist |
No ID Information.