Provider Demographics
NPI:1568637601
Name:HANSEN, RACHEL ENES (MS)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:ENES
Last Name:HANSEN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1785 BAIRD RD
Mailing Address - Street 2:
Mailing Address - City:PENFIELD
Mailing Address - State:NY
Mailing Address - Zip Code:14526-1072
Mailing Address - Country:US
Mailing Address - Phone:585-387-0348
Mailing Address - Fax:
Practice Address - Street 1:1785 BAIRD RD
Practice Address - Street 2:
Practice Address - City:PENFIELD
Practice Address - State:NY
Practice Address - Zip Code:14526-1072
Practice Address - Country:US
Practice Address - Phone:585-387-0344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-29
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003574-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist