Provider Demographics
NPI:1457618464
Name:SCHATZ, RACHAEL (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:RACHAEL
Middle Name:
Last Name:SCHATZ
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 WOODPOND RD
Mailing Address - Street 2:
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410-4312
Mailing Address - Country:US
Mailing Address - Phone:203-439-0880
Mailing Address - Fax:
Practice Address - Street 1:50 WOODPOND RD
Practice Address - Street 2:
Practice Address - City:CHESHIRE
Practice Address - State:CT
Practice Address - Zip Code:06410-4312
Practice Address - Country:US
Practice Address - Phone:203-439-0880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-15
Last Update Date:2012-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003194235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT235Z0000XMedicare Oscar/Certification