Healthcare Provider Details

I. General information

NPI: 1013627223
Provider Name (Legal Business Name): RACHEL PASS M.ED, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2022
Last Update Date: 06/06/2026
Certification Date: 06/06/2026
Deactivation Date: 12/20/2022
Reactivation Date: 01/11/2023

III. Provider practice location address

6075 BARFIELD RD
SANDY SPRINGS GA
30328-4402
US

IV. Provider business mailing address

6075 BARFIELD RD
SANDY SPRINGS GA
30328-4402
US

V. Phone/Fax

Practice location:
  • Phone: 678-347-1165
  • Fax:
Mailing address:
  • Phone: 678-347-1165
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP012737
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: