Provider Demographics
NPI:1669126702
Name:SACKS, RACHEL (MSED CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:
Last Name:SACKS
Suffix:
Gender:F
Credentials:MSED CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 PINE TRL APT 15
Mailing Address - Street 2:
Mailing Address - City:HONEOYE FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14472-1189
Mailing Address - Country:US
Mailing Address - Phone:585-474-6145
Mailing Address - Fax:
Practice Address - Street 1:284 MAIN ST
Practice Address - Street 2:
Practice Address - City:DANSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14437-9753
Practice Address - Country:US
Practice Address - Phone:585-474-6145
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-08
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031626235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist