Provider Demographics
NPI:1588954606
Name:EVERHART, RACHAL NICOLE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:RACHAL
Middle Name:NICOLE
Last Name:EVERHART
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 1:4445 COMANCHE DR
Mailing Address - Street 2:APT. 1
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-3678
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4445 COMANCHE DR
Practice Address - Street 2:APT. 1
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-3678
Practice Address - Country:US
Practice Address - Phone:660-596-3690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-10
Last Update Date:2011-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist