Provider Demographics
NPI:1316353212
Name:GOWER, RACHEAL
Entity type:Individual
Prefix:MRS
First Name:RACHEAL
Middle Name:
Last Name:GOWER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5805 HICKORY HILL RD
Mailing Address - Street 2:
Mailing Address - City:METROPOLIS
Mailing Address - State:IL
Mailing Address - Zip Code:62960-3509
Mailing Address - Country:US
Mailing Address - Phone:618-638-3939
Mailing Address - Fax:
Practice Address - Street 1:2855 N FRIENDSHIP RD
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42001-8605
Practice Address - Country:US
Practice Address - Phone:270-415-5169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-11
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist