Provider Demographics
NPI:1033563937
Name:DORSEY, RACHEL (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:DORSEY
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 E SPENCER ST
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-5607
Mailing Address - Country:US
Mailing Address - Phone:607-882-1816
Mailing Address - Fax:
Practice Address - Street 1:3129 E RIVER RD
Practice Address - Street 2:
Practice Address - City:NICHOLS
Practice Address - State:NY
Practice Address - Zip Code:13812-3224
Practice Address - Country:US
Practice Address - Phone:607-206-6542
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-17
Last Update Date:2018-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist