Provider Demographics
NPI:1104657758
Name:RADFORD, RACHEL (PLPC)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:RADFORD
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1615 HAMPTON AVE APT 17
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63139-3045
Mailing Address - Country:US
Mailing Address - Phone:314-793-2461
Mailing Address - Fax:
Practice Address - Street 1:9666 OLIVE BLVD STE 510
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63132-3026
Practice Address - Country:US
Practice Address - Phone:314-991-0100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-13
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor