Healthcare Provider Details

I. General information

NPI: 1215109897
Provider Name (Legal Business Name): REBECCA KATHLEEN RAGLAND M.S. SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2008
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2930 TOWNLEY CIR
ATLANTA GA
30340-4841
US

IV. Provider business mailing address

2930 TOWNLEY CIR
ATLANTA GA
30340-4841
US

V. Phone/Fax

Practice location:
  • Phone: 405-206-8178
  • Fax:
Mailing address:
  • Phone: 405-206-8178
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number011724
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: