Provider Demographics
NPI:1396273652
Name:COLE, RACHEL E (MA, CF-SLP)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:E
Last Name:COLE
Suffix:
Gender:F
Credentials:MA, CF-SLP
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:E
Other - Last Name:BALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CF-SLP
Mailing Address - Street 1:350 STONEBRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:EL DORADO
Mailing Address - State:AR
Mailing Address - Zip Code:71730-4228
Mailing Address - Country:US
Mailing Address - Phone:870-918-6147
Mailing Address - Fax:
Practice Address - Street 1:214 HOPE LANDING RD
Practice Address - Street 2:
Practice Address - City:EL DORADO
Practice Address - State:AR
Practice Address - Zip Code:71730
Practice Address - Country:US
Practice Address - Phone:870-862-0500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-31
Last Update Date:2018-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR221033721Medicaid