Provider Demographics
NPI:1215409131
Name:VANDERSLICE, RACHEL LEE
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:LEE
Last Name:VANDERSLICE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:LEE
Other - Last Name:CRESCITELLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:1502 SPRUCE AVE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19805-2148
Mailing Address - Country:US
Mailing Address - Phone:302-552-3700
Mailing Address - Fax:
Practice Address - Street 1:1502 SPRUCE AVE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-2148
Practice Address - Country:US
Practice Address - Phone:302-552-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-18
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEO1-0001687235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist