Provider Demographics
NPI:1215673124
Name:HOLSTON, RACHEL EMILY (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:EMILY
Last Name:HOLSTON
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 1:901 N POLLARD ST APT 1109
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22203-4093
Mailing Address - Country:US
Mailing Address - Phone:443-504-3466
Mailing Address - Fax:
Practice Address - Street 1:6715 LITTLE RIVER TPKE STE 200
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-3546
Practice Address - Country:US
Practice Address - Phone:703-879-2479
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-12
Last Update Date:2022-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCSLP000027235Z00000X
VA2202010514235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist