Provider Demographics
NPI:1295970788
Name:ROLLINS, RACHEL ANN (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:ANN
Last Name:ROLLINS
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:MS
Other - First Name:RACHEL
Other - Middle Name:ANN
Other - Last Name:ROLLINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:29 KENNETH LN
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:KY
Mailing Address - Zip Code:42051-9523
Mailing Address - Country:US
Mailing Address - Phone:270-970-1787
Mailing Address - Fax:
Practice Address - Street 1:29 KENNETH LN
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:KY
Practice Address - Zip Code:42051
Practice Address - Country:US
Practice Address - Phone:270-970-1787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-11
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
KY337803235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist