Provider Demographics
NPI:1316564933
Name:SPENCER, RACHEL MARIE (AUD)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:MARIE
Last Name:SPENCER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:MARIE
Other - Last Name:EDWARDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9140 BONITA BEACH RD SE
Mailing Address - Street 2:
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34135-4291
Mailing Address - Country:US
Mailing Address - Phone:239-593-5327
Mailing Address - Fax:
Practice Address - Street 1:971 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103
Practice Address - Country:US
Practice Address - Phone:239-593-5327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-30
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY2375231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist