Provider Demographics
NPI:1801232780
Name:AGHARA, RACHEL GREENBLATT (PHD, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:GREENBLATT
Last Name:AGHARA
Suffix:
Gender:F
Credentials:PHD, CCC-SLP
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:LYNN
Other - Last Name:GREENBLATT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12 BROOKSIDE RD UNIT 23
Mailing Address - Street 2:
Mailing Address - City:WESTFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01886-2087
Mailing Address - Country:US
Mailing Address - Phone:512-775-7706
Mailing Address - Fax:
Practice Address - Street 1:43 DARTMOUTH ST
Practice Address - Street 2:
Practice Address - City:MALDEN
Practice Address - State:MA
Practice Address - Zip Code:02148-5103
Practice Address - Country:US
Practice Address - Phone:781-306-4820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-17
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8862235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist