Provider Demographics
NPI:1063619690
Name:SCHALLER, RACHEL (SPEECH LANGUAGE PATH)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:SCHALLER
Suffix:
Gender:F
Credentials:SPEECH LANGUAGE PATH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12882 LONGLEAF LN
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-9183
Mailing Address - Country:US
Mailing Address - Phone:317-771-5459
Mailing Address - Fax:
Practice Address - Street 1:12882 LONGLEAF LANE
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-1983
Practice Address - Country:US
Practice Address - Phone:317-771-5459
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-28
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22004499A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist