Provider Demographics
NPI:1265738413
Name:LEDGER, RACHELLE (SLP)
Entity type:Individual
Prefix:
First Name:RACHELLE
Middle Name:
Last Name:LEDGER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1145 W BASELINE RD
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:MI
Mailing Address - Zip Code:49455-9247
Mailing Address - Country:US
Mailing Address - Phone:231-873-3577
Mailing Address - Fax:231-873-3557
Practice Address - Street 1:601 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HART
Practice Address - State:MI
Practice Address - Zip Code:49420-1144
Practice Address - Country:US
Practice Address - Phone:231-873-3577
Practice Address - Fax:231-873-3557
Is Sole Proprietor?:No
Enumeration Date:2011-02-07
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
01119198OtherSLP CERTIFICATION NUMBER