Provider Demographics
NPI:1912197989
Name:SILFVAST, RACHEL DANIELLE (LMBT)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:DANIELLE
Last Name:SILFVAST
Suffix:
Gender:F
Credentials:LMBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 MILLS AVE
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29605-4015
Mailing Address - Country:US
Mailing Address - Phone:864-233-5513
Mailing Address - Fax:864-233-5531
Practice Address - Street 1:23 MILLS AVE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-4015
Practice Address - Country:US
Practice Address - Phone:864-233-5513
Practice Address - Fax:864-233-5531
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4791225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist