Provider Demographics
NPI:1831335785
Name:DEMARCO, RACHAEL LEIGH (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:RACHAEL
Middle Name:LEIGH
Last Name:DEMARCO
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8879 KILKENNY DR
Mailing Address - Street 2:
Mailing Address - City:BALDWINSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13027-9066
Mailing Address - Country:US
Mailing Address - Phone:315-729-9982
Mailing Address - Fax:
Practice Address - Street 1:8879 KILKENNY DR
Practice Address - Street 2:
Practice Address - City:BALDWINSVILLE
Practice Address - State:NY
Practice Address - Zip Code:13027-9066
Practice Address - Country:US
Practice Address - Phone:315-729-9982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-24
Last Update Date:2008-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012916-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist