Provider Demographics
NPI:1275172793
Name:REHAB RISING, PLLC
Entity Type:Organization
Organization Name:REHAB RISING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER AND CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TAYLOR
Authorized Official - Middle Name:
Authorized Official - Last Name:HICKOK
Authorized Official - Suffix:
Authorized Official - Credentials:DBH, CCC-SLP
Authorized Official - Phone:949-246-7883
Mailing Address - Street 1:4305 WINDSONG CIR
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27539-7964
Mailing Address - Country:US
Mailing Address - Phone:919-747-3737
Mailing Address - Fax:
Practice Address - Street 1:4305 WINDSONG CIR
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27539-7964
Practice Address - Country:US
Practice Address - Phone:919-747-3737
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-01
Last Update Date:2020-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty