Provider Demographics
NPI:1467860031
Name:RYAN, RACHEL (SLP)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:RYAN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:HILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:2500 W STRUB RD STE 150
Mailing Address - Street 2:
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44870-5488
Mailing Address - Country:US
Mailing Address - Phone:419-626-4162
Mailing Address - Fax:419-626-1268
Practice Address - Street 1:2500 W STRUB RD STE 150
Practice Address - Street 2:
Practice Address - City:SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:44870-5488
Practice Address - Country:US
Practice Address - Phone:419-626-4162
Practice Address - Fax:419-626-1268
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-28
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP11379235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist