Provider Demographics
NPI:1295078160
Name:OGONOWSKI, RACHEL SHELBY (SLP)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:SHELBY
Last Name:OGONOWSKI
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:RACHEL
Other - Last Name:SHELBY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:1623 AVONDALE DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27701-1416
Mailing Address - Country:US
Mailing Address - Phone:919-815-1655
Mailing Address - Fax:
Practice Address - Street 1:1829 E FRANKLIN ST
Practice Address - Street 2:BLDG. 600
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-5861
Practice Address - Country:US
Practice Address - Phone:919-968-3456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-29
Last Update Date:2014-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10310235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist