Provider Demographics
NPI:1750860417
Name:FORBIS, RACHAEL SMYERS
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:SMYERS
Last Name:FORBIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2819 FOSTER LN APT F241
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78757-1192
Mailing Address - Country:US
Mailing Address - Phone:940-210-8273
Mailing Address - Fax:
Practice Address - Street 1:2819 FOSTER LN APT F241
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78757-1192
Practice Address - Country:US
Practice Address - Phone:940-210-8273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-13
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113196235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist