Provider Demographics
NPI:1982894895
Name:GREENE, RACHEL ALICE (MS CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:ALICE
Last Name:GREENE
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 1:1999 S MAIN ST STE 303
Mailing Address - Street 2:
Mailing Address - City:BLACKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24060-6601
Mailing Address - Country:US
Mailing Address - Phone:540-486-5375
Mailing Address - Fax:540-486-5403
Practice Address - Street 1:1999 S MAIN ST STE 303
Practice Address - Street 2:
Practice Address - City:BLACKSBURG
Practice Address - State:VA
Practice Address - Zip Code:24060-6601
Practice Address - Country:US
Practice Address - Phone:540-486-5375
Practice Address - Fax:540-486-5403
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2019-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202005276235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist