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General NPI Number Information
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NPI Number | 1396261921
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Entity Type | Individual
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Provider Name | RACHEL ANN RUSNAK M.A.ED CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 08/15/2017
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Last Update Date | 12/15/2021
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Provider Practice Location Address
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Address Line | 6437 RUCKER RD
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City | INDIANAPOLIS
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State | IN
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Zip | 46220-4885
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Country | US
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Telephone | 317-270-0052
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Fax |
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Provider Business Mailing Address
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Address Line | 12950 CORYDON DR
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City | FISHERS
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State | IN
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Zip | 46037-4627
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Country | US
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Telephone | 317-270-0052
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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 | 242003802
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 22006995A
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License Number State | IN
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