Provider Demographics
NPI:1962944413
Name:LEVINE, RACHEL ANNE (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:ANNE
Last Name:LEVINE
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 1:799 CAPELLA CIR
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-1497
Mailing Address - Country:US
Mailing Address - Phone:541-944-8886
Mailing Address - Fax:
Practice Address - Street 1:542 WASHINGTON ST STE 102
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-1796
Practice Address - Country:US
Practice Address - Phone:541-944-8886
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-15
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR17071235Z00000X
WA520632A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist