Provider Demographics
NPI:1982274544
Name:HEALY, MADISON RACHOW (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MADISON
Middle Name:RACHOW
Last Name:HEALY
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 1:275 SARATOGA AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95050-6667
Mailing Address - Country:US
Mailing Address - Phone:408-337-2727
Mailing Address - Fax:
Practice Address - Street 1:275 SARATOGA AVE
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95050-6667
Practice Address - Country:US
Practice Address - Phone:408-337-2727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist