Provider Demographics
NPI:1679306021
Name:MCKUIN, RACHEL MICHELLE
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:MICHELLE
Last Name:MCKUIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 453
Mailing Address - Street 2:
Mailing Address - City:MONETTE
Mailing Address - State:AR
Mailing Address - Zip Code:72447-0453
Mailing Address - Country:US
Mailing Address - Phone:573-717-6352
Mailing Address - Fax:
Practice Address - Street 1:105 N OAK ST
Practice Address - Street 2:
Practice Address - City:BROOKLAND
Practice Address - State:AR
Practice Address - Zip Code:72417-8831
Practice Address - Country:US
Practice Address - Phone:870-227-4199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-21
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2029132355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant