Provider Demographics
NPI:1356779003
Name:RICHARDS, RACHAEL ELIZABETH (MS SLP)
Entity type:Individual
Prefix:
First Name:RACHAEL
Middle Name:ELIZABETH
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:MS SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1580 COUNTY ROUTE 58
Mailing Address - Street 2:
Mailing Address - City:COLTON
Mailing Address - State:NY
Mailing Address - Zip Code:13625-4102
Mailing Address - Country:US
Mailing Address - Phone:315-212-3721
Mailing Address - Fax:
Practice Address - Street 1:1580 COUNTY ROUTE 58
Practice Address - Street 2:
Practice Address - City:COLTON
Practice Address - State:NY
Practice Address - Zip Code:13625-4102
Practice Address - Country:US
Practice Address - Phone:315-212-3721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-16
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist