Provider Demographics
NPI:1053032144
Name:ERGLE, RACHEL LEE
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:LEE
Last Name:ERGLE
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 1:1909 LAKE BALDWIN LN UNIT 302
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32814-6928
Mailing Address - Country:US
Mailing Address - Phone:850-774-7102
Mailing Address - Fax:
Practice Address - Street 1:9682 LAKE NONA VILLAGE PL
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32827-7315
Practice Address - Country:US
Practice Address - Phone:321-236-6977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-07
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist