Provider Demographics
NPI:1689467920
Name:WALTHALL, RACHEL KATHLEEN (SLP)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:KATHLEEN
Last Name:WALTHALL
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 TRIAD CENTER DR STE A
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-7351
Mailing Address - Country:US
Mailing Address - Phone:314-598-0678
Mailing Address - Fax:833-638-0807
Practice Address - Street 1:1400 TRIAD CENTER DR STE A
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-7351
Practice Address - Country:US
Practice Address - Phone:314-254-2188
Practice Address - Fax:833-638-0807
Is Sole Proprietor?:No
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist