Provider Demographics
NPI:1053986554
Name:KOKICHI-BURNLEY, RACHEL MELAANI (TMFT)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:MELAANI
Last Name:KOKICHI-BURNLEY
Suffix:
Gender:F
Credentials:TMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6200 AURORA AVE STE 305E
Mailing Address - Street 2:
Mailing Address - City:URBANDALE
Mailing Address - State:IA
Mailing Address - Zip Code:50322-2863
Mailing Address - Country:US
Mailing Address - Phone:515-724-8920
Mailing Address - Fax:888-771-3225
Practice Address - Street 1:6200 AURORA AVE STE 305E
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-2863
Practice Address - Country:US
Practice Address - Phone:515-724-8920
Practice Address - Fax:888-771-3225
Is Sole Proprietor?:No
Enumeration Date:2021-05-26
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA106215106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist