Raechel Christeene Hataway, MS, CF-SLP
Individual provider Active NPI Speech-Language Pathologist · Teague, TX
NPI 1568698207 · NPPES record last updated Oct 14, 2024
Key facts
- NPI
- 1568698207
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 105075 (TX)
- Practice address
- 420 N 10TH Ave
Teague, TX 75860-1218 - Phone
- (254) 739-1350
- Fax
- (254) 519-3477
- NPI assigned
- Jun 9, 2009
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| 105075 | TX | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 105075 | TX | Yes |
Addresses
Primary practice location
420 N 10TH Ave
Teague, TX 75860-1218
Mailing address
101 Western Ridge Rd
Gatesville, TX 76528-9400
Phone (254) 223-2542
Other names
- Ms. Raechel Christeene Erwin
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- Robin Louise Johnson
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All providers in Teague, TX · Speech-Language Pathologist in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 14, 2024. 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.