Provider Demographics
NPI:1104310861
Name:DOVALES, RAQUEL JONAE (ATC)
Entity type:Individual
Prefix:
First Name:RAQUEL
Middle Name:JONAE
Last Name:DOVALES
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1129 ASHBOURNE DR
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19605-3225
Mailing Address - Country:US
Mailing Address - Phone:610-743-0978
Mailing Address - Fax:
Practice Address - Street 1:1129 ASHBOURNE DR
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19605-3225
Practice Address - Country:US
Practice Address - Phone:610-743-0978
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-17
Last Update Date:2018-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer