Healthcare Provider Details

I. General information

NPI: 1558987396
Provider Name (Legal Business Name): RACHEL TART BARGER M.S. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2020
Last Update Date: 06/17/2020
Certification Date: 06/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 FAIRY TRL
LOOKOUT MOUNTAIN TN
37350-1606
US

IV. Provider business mailing address

PO BOX 131
LOOKOUT MOUNTAIN TN
37350-0131
US

V. Phone/Fax

Practice location:
  • Phone: 704-575-1669
  • Fax:
Mailing address:
  • Phone: 704-575-1669
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: