Basic Information
| Provider Information | |||||||||
| NPI: | 1760654610 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BARTLEY | ||||||||
| FirstName: | RACHEL | ||||||||
| MiddleName: | LAUREN | ||||||||
| NamePrefix: | MS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 200 AVENUE F NE | ||||||||
| Address2: | BEHAVIORAL HEALTH DIVISION | ||||||||
| City: | WINTER HAVEN | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33881 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8632931121 | ||||||||
| FaxNumber: | 8632916084 | ||||||||
| Practice Location | |||||||||
| Address1: | 1201 FIRST STREET SOUTH | ||||||||
| Address2: | |||||||||
| City: | WINTER HAVEN | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33880 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8632947062 | ||||||||
| FaxNumber: | 8632916084 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/01/2008 | ||||||||
| LastUpdateDate: | 04/01/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171M00000X | Y | Other Service Providers | Case Manager/Care Coordinator |
No ID Information.