Provider Demographics
NPI:1578884953
Name:NOLAN, RACHAEL (MA CCC- SLP)
Entity Type:Individual
Prefix:MRS
First Name:RACHAEL
Middle Name:
Last Name:NOLAN
Suffix:
Gender:F
Credentials:MA CCC- SLP
Other - Prefix:
Other - First Name:RACHAEL
Other - Middle Name:
Other - Last Name:HYMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA CCC-SLP
Mailing Address - Street 1:2575 GLASGOW AVE
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-4747
Mailing Address - Country:US
Mailing Address - Phone:619-496-6917
Mailing Address - Fax:
Practice Address - Street 1:2575 GLASGOW AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-4747
Practice Address - Country:US
Practice Address - Phone:619-496-6917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-19
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEO1-0012076235Z00000X
PASL010427235Z00000X
235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist