Basic Information
| Provider Information | |||||||||
| NPI: | 1477889855 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ZUCKMAN | ||||||||
| FirstName: | RACHEL | ||||||||
| MiddleName: | ZOE | ||||||||
| NamePrefix: | MISS | ||||||||
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| Credential: | MA/CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 101 E STATE ST | ||||||||
| Address2: | |||||||||
| City: | KENNETT SQUARE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 193483109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6104446350 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3590 WASHINGTON PIKE | ||||||||
| Address2: | |||||||||
| City: | BRIDGEVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 150171047 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4122572474 | ||||||||
| FaxNumber: | 4122574521 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/20/2009 | ||||||||
| LastUpdateDate: | 10/20/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.