Healthcare Provider Details

I. General information

NPI: 1205036175
Provider Name (Legal Business Name): RACHEL BANE RAPER ASHA CERTIFIED
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2007
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

954 GUION DR
LUGOFF SC
29078-9344
US

IV. Provider business mailing address

PO BOX 412
ELGIN SC
29045-0412
US

V. Phone/Fax

Practice location:
  • Phone: 803-530-7917
  • Fax: 888-581-6128
Mailing address:
  • Phone: 803-530-7917
  • Fax: 888-581-8543

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number4162
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: