Basic Information
| Provider Information | |||||||||
| NPI: | 1881852960 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MARTINA | ||||||||
| FirstName: | RACHEL | ||||||||
| MiddleName: | ANN | ||||||||
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| Credential: | SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3700 GRANT DR | ||||||||
| Address2: | STE A | ||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 89509 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7758294700 | ||||||||
| FaxNumber: | 7758294710 | ||||||||
| Practice Location | |||||||||
| Address1: | 3700 GRANT DR | ||||||||
| Address2: | STE A | ||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 89509 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6192780884 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/27/2008 | ||||||||
| LastUpdateDate: | 03/09/2011 | ||||||||
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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 | 2355S0801X | 469 | CA | N | Speech, Language and Hearing Service Providers | Specialist/Technologist | Speech-Language Assistant | 235Z00000X | SP-1352 | NV | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.