Individual
KENNETH CHRIS RACHAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD, MP
Contact information
Practice address
142A RUE MARGUERITE, THIBODAUX, LA 70301-6738
(985) 625-0023
(985) 625-0022
Mailing address
142A RUE MARGUERITE, THIBODAUX, LA 70301-6738
(985) 625-0023
(985) 625-0022
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
895
LA
103TC1900X
Counseling Psychologist
895
LA
103TP0016X
Prescribing (Medical) Psychologist
Primary
MP.0014
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1130354
—
LA
Enumeration date
07/01/2005
Last updated
05/01/2014
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