Provider Demographics
NPI:1427103001
Name:WALDEN, RACHAEL MARY (MS/ SLP)
Entity type:Individual
Prefix:MRS
First Name:RACHAEL
Middle Name:MARY
Last Name:WALDEN
Suffix:
Gender:F
Credentials:MS/ SLP
Other - Prefix:MISS
Other - First Name:RACHAEL
Other - Middle Name:MARY
Other - Last Name:LANNOM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS/SLP
Mailing Address - Street 1:1155 MILL ST
Mailing Address - Street 2:MS M14
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-1576
Mailing Address - Country:US
Mailing Address - Phone:775-982-5262
Mailing Address - Fax:775-982-3900
Practice Address - Street 1:1664 N VIRGINIA ST MAIL STOP 152
Practice Address - Street 2:REDFIELD MEDICAL BLDG
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89557-0152
Practice Address - Country:US
Practice Address - Phone:775-784-4887
Practice Address - Fax:775-784-4095
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVSP-725235Z00000X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100500895Medicaid
NVSP#725OtherBOARD OF EXAMINERS
NV29-6505Medicare ID - Type Unspecified