Provider Demographics
NPI:1053979971
Name:HANLEY, RACHEL NAOMI (MS CCC SLP)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:NAOMI
Last Name:HANLEY
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 1:17270 RUSSETT FARM DR
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:PA
Mailing Address - Zip Code:17361-1769
Mailing Address - Country:US
Mailing Address - Phone:410-258-8834
Mailing Address - Fax:
Practice Address - Street 1:900 WOODBOURNE AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21212-4027
Practice Address - Country:US
Practice Address - Phone:443-642-4204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-05
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05539235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist