Provider Information for 1639612575
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RACHELE MARLETTE MSW
Sex: Female
NPI: 1639612575
Last Updated: 2025-03-21
Certification Date: 2025-03-21
Certification Date: 2025-03-21
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1639612575 | ||||||||
| Enumeration Date | 2016-11-27 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | PO BOX 40534 GRAND JCT, CO 81504-0534 United States Phone: 970-314-6675 | Fax: | ||||||||
| Primary Practice Address | 125 N 8TH ST UNIT 9 GRAND JCT, CO 81501-3533 United States Phone: 970-314-6675 | Fax: | ||||||||
| Secondary Practice Address(es) | 1000 N 9TH ST | ||||||||
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