Provider Demographics
NPI:1104593037
Name:DONALDSON, RACHEL ALLISON
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:ALLISON
Last Name:DONALDSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1524 CHESTERLAND AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-4824
Mailing Address - Country:US
Mailing Address - Phone:216-235-4340
Mailing Address - Fax:
Practice Address - Street 1:2601 POLE AVE
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44052-4303
Practice Address - Country:US
Practice Address - Phone:440-830-4041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-27
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOND.20211830-SP235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHOH3391167OtherOHIO BOARD OF EDUCATION - 5-YEAR PUPIL SERVICES
OHCOND.20211830-SPOtherOHIO SPEECH AND HEARING PROFESSIONALS BOARD