Individual
MS. RACHEL DEBOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
602 VONDERBURG DR, SUITE 201, BRANDON, FL 33511-5900
(813) 653-1149
(813) 654-6644
Mailing address
602 VONDERBURG DR, SUITE 201, BRANDON, FL 33511-5900
(813) 653-1149
(813) 654-6644
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
FL
2355S0801X
Speech-Language Assistant
SI1326
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001103800
—
FL
Enumeration date
06/28/2007
Last updated
04/07/2011
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