Provider Demographics
NPI:1831676691
Name:SMITH, RACHEL
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:SMITH
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 1:10916 SERENBE LANE, PALMETTO, GA, USA
Mailing Address - Street 2:
Mailing Address - City:PALMETTO
Mailing Address - State:GA
Mailing Address - Zip Code:30268-3516
Mailing Address - Country:US
Mailing Address - Phone:140-496-0614
Mailing Address - Fax:
Practice Address - Street 1:10916 SERENBE LN
Practice Address - Street 2:
Practice Address - City:CHATTAHOOCHEE HILLS
Practice Address - State:GA
Practice Address - Zip Code:30268-2496
Practice Address - Country:US
Practice Address - Phone:404-960-6142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-25
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAHADS000991237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist