Provider Demographics
NPI:1225825714
Name:PARKER, RACHAEL LEE
Entity type:Individual
Prefix:
First Name:RACHAEL
Middle Name:LEE
Last Name:PARKER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:RACHAEL
Other - Middle Name:LEE
Other - Last Name:KELLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1908 KRUCHTEN CT S
Mailing Address - Street 2:
Mailing Address - City:SARTELL
Mailing Address - State:MN
Mailing Address - Zip Code:56377-4645
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1908 KRUCHTEN CT S
Practice Address - Street 2:
Practice Address - City:SARTELL
Practice Address - State:MN
Practice Address - Zip Code:56377-4645
Practice Address - Country:US
Practice Address - Phone:320-640-7660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician