Provider Demographics
NPI:1205036175
Name:RAPER, RACHEL BANE (ASHA CERTIFIED)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:BANE
Last Name:RAPER
Suffix:
Gender:F
Credentials:ASHA CERTIFIED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 412
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:SC
Mailing Address - Zip Code:29045-0412
Mailing Address - Country:US
Mailing Address - Phone:803-530-7917
Mailing Address - Fax:888-581-8543
Practice Address - Street 1:100 BRAMBLE RD
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:SC
Practice Address - Zip Code:29045-8669
Practice Address - Country:US
Practice Address - Phone:803-530-7917
Practice Address - Fax:888-581-6128
Is Sole Proprietor?:No
Enumeration Date:2007-07-19
Last Update Date:2012-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4162235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist