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General NPI Number Information
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NPI Number | 1801456280
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Entity Type | Individual
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Provider Name | RACHAEL O'BRIEN
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Gender | Female
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Dates
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Enumeration Date | 06/18/2019
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Last Update Date | 06/18/2019
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Provider Practice Location Address
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Address Line | 2529 DETROIT AVE STE 136
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City | CLEVELAND
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State | OH
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Zip | 44113-2701
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Country | US
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Telephone | 419-271-1629
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Fax |
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Provider Business Mailing Address
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Address Line | 3360 AVALON RD
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City | SHAKER HEIGHTS
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State | OH
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Zip | 44120-3416
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Country | US
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Telephone |
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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 | 09025
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License Number State | OH
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