Rachelle Elisabeth Brosnan, M.S., CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Jackson, MO
NPI 1164034781 · NPPES record last updated Sep 18, 2020
Key facts
- NPI
- 1164034781
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 2017005986 (MO)
- Practice address
- 614 E Adams St
Jackson, MO 63755-2150 - Phone
- (573) 243-9501
- NPI assigned
- Aug 17, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2017005986 | MO | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jackson R-2 Schools | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2017005986 | MO | Yes |
Addresses
Primary practice location
614 E Adams St
Jackson, MO 63755-2150
Mailing address
614 E Adams St
Jackson, MO 63755-2150
Phone (573) 243-9501
Other providers in Jackson, MO
- Cassandra Bollinger
- Erica Danielle Bowles
- Jamie Christine Bowles
- Shelbee Laine Boyer
- Betsy Brake
- Amy Elizabeth Brueckner
- Chelsea Ann Bucher
- Lacy Bucher
- Deanna Maria Buchheit
- Laura Lee Buchheit
All providers in Jackson, MO · Speech-Language Pathologist in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 18, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.