Provider Demographics
NPI:1164093829
Name:MILES, RACHEL JULIANNE (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:JULIANNE
Last Name:MILES
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 1:377 HOUGH LN
Mailing Address - Street 2:
Mailing Address - City:SMITHTON
Mailing Address - State:PA
Mailing Address - Zip Code:15479-8745
Mailing Address - Country:US
Mailing Address - Phone:724-961-6328
Mailing Address - Fax:
Practice Address - Street 1:102 EQUITY DR
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-7190
Practice Address - Country:US
Practice Address - Phone:724-836-2460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-05
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02300L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist