1801232780 NPI number — RACHEL GREENBLATT AGHARA PHD, CCC-SLP

Table of content: MS. GRETTA MCCALL M.ED., LPC (NPI 1831455625)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801232780 NPI number — RACHEL GREENBLATT AGHARA PHD, CCC-SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AGHARA
Provider First Name:
RACHEL
Provider Middle Name:
GREENBLATT
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PHD, CCC-SLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GREENBLATT
Provider Other First Name:
RACHEL
Provider Other Middle Name:
LYNN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1801232780
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/17/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12 BROOKSIDE RD UNIT 23
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WESTFORD
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01886-2087
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-775-7706
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
43 DARTMOUTH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MALDEN
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02148-5103
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
781-306-4820
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/17/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  8862 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com