Provider Demographics
NPI:1669777355
Name:QUINN, RACHEL AMBER (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:AMBER
Last Name:QUINN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MISS
Other - First Name:RACHEL
Other - Middle Name:AMBER
Other - Last Name:POPPELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:707 FRANKIE LANE DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32310-1154
Mailing Address - Country:US
Mailing Address - Phone:850-443-7109
Mailing Address - Fax:850-727-7665
Practice Address - Street 1:707 FRANKIE LANE DR
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32310-1154
Practice Address - Country:US
Practice Address - Phone:850-443-7109
Practice Address - Fax:850-727-7665
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-11
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 10636235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist