Basic Information
| Provider Information | |||||||||
| NPI: | 1295078160 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | OGONOWSKI | ||||||||
| FirstName: | RACHEL | ||||||||
| MiddleName: | SHELBY | ||||||||
| NamePrefix: | |||||||||
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| Credential: | SLP | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | SHELBY | ||||||||
| OtherFirstName: | ELIZABETH | ||||||||
| OtherMiddleName: | RACHEL | ||||||||
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| OtherCredential: | SLP | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1623 AVONDALE DR | ||||||||
| Address2: | |||||||||
| City: | DURHAM | ||||||||
| State: | NC | ||||||||
| PostalCode: | 277011416 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9198151655 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1829 E FRANKLIN ST | ||||||||
| Address2: | BLDG. 600 | ||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275145861 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199683456 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/29/2013 | ||||||||
| LastUpdateDate: | 12/19/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 10310 | NC | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.