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General NPI Number Information
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NPI Number | 1235747312
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Entity Type | Individual
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Provider Name | RACHEL RENEE KACZMARCZYK
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Gender | Female
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Dates
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Enumeration Date | 07/15/2020
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 11200 WAPLES MILL RD STE 100
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City | FAIRFAX
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State | VA
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Zip | 22030-7475
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Country | US
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Telephone | 703-237-2219
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Fax |
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Provider Business Mailing Address
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Address Line | 14713 WINTERFIELD CT
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City | CENTREVILLE
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State | VA
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Zip | 20120-2939
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Country | US
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Telephone | 703-424-0165
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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