Healthcare Provider Details

I. General information

NPI: 1780653667
Provider Name (Legal Business Name): RACHEL A BABOIAN AUD CCC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 10/16/2024
Certification Date: 10/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 BLACKSTONE VALLEY PL BLDG 3, SUITE 307
LINCOLN RI
02865-1179
US

IV. Provider business mailing address

131 COOPER RD
CHEPACHET RI
02814-1445
US

V. Phone/Fax

Practice location:
  • Phone: 401-475-6116
  • Fax: 401-475-6616
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAUD00152
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: