Provider Demographics
NPI:1750561080
Name:RANKIN, EVELYN MAE (MSCCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:EVELYN
Middle Name:MAE
Last Name:RANKIN
Suffix:
Gender:F
Credentials:MSCCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:274 PLYMOUTH ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02346-1214
Mailing Address - Country:US
Mailing Address - Phone:508-946-1588
Mailing Address - Fax:
Practice Address - Street 1:105 E GROVE ST
Practice Address - Street 2:
Practice Address - City:MIDDLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02346-2743
Practice Address - Country:US
Practice Address - Phone:508-947-3634
Practice Address - Fax:508-946-1088
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-03
Last Update Date:2007-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2529235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist