Provider Demographics
NPI:1164953592
Name:HENRY, RACHAEL BEEBE (MSP, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:BEEBE
Last Name:HENRY
Suffix:
Gender:F
Credentials:MSP, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 MEETING ST
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:SC
Mailing Address - Zip Code:29440-3749
Mailing Address - Country:US
Mailing Address - Phone:843-509-7666
Mailing Address - Fax:
Practice Address - Street 1:327 MEETING ST
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:SC
Practice Address - Zip Code:29440-3749
Practice Address - Country:US
Practice Address - Phone:843-509-7666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-27
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC235Z00000X
SC5443235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist