Provider Demographics
NPI:1497189450
Name:CLOW, RACHEL LEAH (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:LEAH
Last Name:CLOW
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MISS
Other - First Name:RACHEL
Other - Middle Name:LEAH
Other - Last Name:WALSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:708 E 11TH PL
Mailing Address - Street 2:
Mailing Address - City:BIG SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:79720-4648
Mailing Address - Country:US
Mailing Address - Phone:432-264-4106
Mailing Address - Fax:
Practice Address - Street 1:708 E 11TH PL
Practice Address - Street 2:
Practice Address - City:BIG SPRING
Practice Address - State:TX
Practice Address - Zip Code:79720-4648
Practice Address - Country:US
Practice Address - Phone:432-264-4106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-27
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108122235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist