Provider Demographics
NPI:1417687211
Name:KILPATRICK, RACHEL M (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:M
Last Name:KILPATRICK
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9270 GAYSPORT HILL RD
Mailing Address - Street 2:
Mailing Address - City:BLUE ROCK
Mailing Address - State:OH
Mailing Address - Zip Code:43720-9615
Mailing Address - Country:US
Mailing Address - Phone:740-624-3863
Mailing Address - Fax:
Practice Address - Street 1:9270 GAYSPORT HILL RD
Practice Address - Street 2:
Practice Address - City:BLUE ROCK
Practice Address - State:OH
Practice Address - Zip Code:43720-9615
Practice Address - Country:US
Practice Address - Phone:740-624-3863
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-14
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.12919235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist