Provider Demographics
NPI:1790406361
Name:KABOTYANSKY, RACHEL (MS, CF-SLP)
Entity Type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:
Last Name:KABOTYANSKY
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19380 COLLINS AVE APT 1620
Mailing Address - Street 2:
Mailing Address - City:SUNNY ISLES BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-2457
Mailing Address - Country:US
Mailing Address - Phone:732-241-7811
Mailing Address - Fax:
Practice Address - Street 1:4103 N 48TH TER
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-1752
Practice Address - Country:US
Practice Address - Phone:732-241-7811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ10787235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist