Provider Demographics
NPI:1689410821
Name:BLANKENSHIP, RACHEL SUZANNE
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:SUZANNE
Last Name:BLANKENSHIP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:SUZANNE
Other - Last Name:HARBIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:414 GRAND OAKS RD
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32317-1434
Mailing Address - Country:US
Mailing Address - Phone:901-517-9792
Mailing Address - Fax:
Practice Address - Street 1:4200 NORTHSIDE PKWY NW
Practice Address - Street 2:BLDG 14 SUITE 100
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327
Practice Address - Country:US
Practice Address - Phone:770-726-9589
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health