Provider Demographics
NPI:1710466958
Name:GENRICH, RACHEL ADELE (CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:ADELE
Last Name:GENRICH
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 1:6636 ROYAL OAK CT
Mailing Address - Street 2:
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-1623
Mailing Address - Country:US
Mailing Address - Phone:770-653-8564
Mailing Address - Fax:
Practice Address - Street 1:6035 PEACHTREE RD
Practice Address - Street 2:
Practice Address - City:DORAVILLE
Practice Address - State:GA
Practice Address - Zip Code:30360-3230
Practice Address - Country:US
Practice Address - Phone:678-514-3270
Practice Address - Fax:678-279-7370
Is Sole Proprietor?:No
Enumeration Date:2018-08-08
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist