Provider Demographics
NPI:1174979736
Name:DLUGOSIELSKI, RACHEL (MS SLP)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:DLUGOSIELSKI
Suffix:
Gender:F
Credentials:MS SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79981 DELAND RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:MI
Mailing Address - Zip Code:48062-2208
Mailing Address - Country:US
Mailing Address - Phone:586-557-7221
Mailing Address - Fax:
Practice Address - Street 1:2320 REDBRIDGE LN
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-2495
Practice Address - Country:US
Practice Address - Phone:919-925-4922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-12
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
MI7101005100235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist