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KENNETH CHRIS RACHAL PHD, MP

Clinical Neuropsychologist

Thibodaux, Louisiana

Provider NPI: 1871590067

Provider Information:
 KENNETH CHRIS RACHAL PHD, MP
Gender: M
Sole Proprietor


Practice Location:
142A RUE MARGUERITE  THIBODAUX, LA 70301 US
Tel: 985-625-0023  Fax: 985-625-0022

Business Mailing Address:
142A RUE MARGUERITE  THIBODAUX, LA 70301 US
Tel: 985-625-0023  Fax: 985-625-0022

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
LA895
Y103TP0016XBehavioral Health & Social Service Providers
Psychologist
LAMP.0014
N103TC1900XBehavioral Health & Social Service Providers
Psychologist
LA895

Other Provider Identifiers:

IssuerNumberStateType
5DU94LA02
1130354LA05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







CLINICAL NEUROPSYCHOLOGIST JOBS LA - Page 1



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