Provider Demographics
NPI:1235561929
Name:POPOV, RACHEL VACHON
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:VACHON
Last Name:POPOV
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:189 WIND CHIME CT
Mailing Address - Street 2:SUITE 101
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-6479
Mailing Address - Country:US
Mailing Address - Phone:919-324-3828
Mailing Address - Fax:888-804-2664
Practice Address - Street 1:189 WIND CHIME CT
Practice Address - Street 2:SUITE 101
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-6479
Practice Address - Country:US
Practice Address - Phone:919-324-3828
Practice Address - Fax:888-804-2664
Is Sole Proprietor?:No
Enumeration Date:2013-08-05
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist