Healthcare Provider Details

I. General information

NPI: 1811792013
Provider Name (Legal Business Name): RACHEL IASSOGNA M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2025
Last Update Date: 02/13/2025
Certification Date: 02/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 PROGRESS DR
SHELTON CT
06484-6293
US

IV. Provider business mailing address

55 WENDOVER RD
TRUMBULL CT
06611-1529
US

V. Phone/Fax

Practice location:
  • Phone: 475-239-5512
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number007227
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: