Healthcare Provider Details

I. General information

NPI: 1629906458
Provider Name (Legal Business Name): MS. EMILY RACHEL HERBST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5321 EPHESUS CHURCH RD
DURHAM NC
27707-9722
US

IV. Provider business mailing address

125 ENFIELD DR
CARTHAGE NC
28327-0705
US

V. Phone/Fax

Practice location:
  • Phone: 919-560-3919
  • Fax:
Mailing address:
  • Phone: 910-587-5846
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number30004327
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: