Provider Demographics
NPI:1538553672
Name:HOVLAND, RACHEAL (MA CCC-SLP)
Entity type:Individual
Prefix:
First Name:RACHEAL
Middle Name:
Last Name:HOVLAND
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 W CHARLOTTE ST
Mailing Address - Street 2:
Mailing Address - City:RIVER FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54022-2847
Mailing Address - Country:US
Mailing Address - Phone:715-426-2047
Mailing Address - Fax:
Practice Address - Street 1:310 W CHARLOTTE ST
Practice Address - Street 2:
Practice Address - City:RIVER FALLS
Practice Address - State:WI
Practice Address - Zip Code:54022-2847
Practice Address - Country:US
Practice Address - Phone:715-426-2047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-26
Last Update Date:2015-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2753-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist