Provider Demographics
NPI:1609979921
Name:RANCHOD, RAJAL (MED, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:RAJAL
Middle Name:
Last Name:RANCHOD
Suffix:
Gender:F
Credentials:MED, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5960 WILD TIMBER RD
Mailing Address - Street 2:
Mailing Address - City:SUGAR HILL
Mailing Address - State:GA
Mailing Address - Zip Code:30518-5689
Mailing Address - Country:US
Mailing Address - Phone:770-831-7507
Mailing Address - Fax:
Practice Address - Street 1:5960 WILD TIMBER RD
Practice Address - Street 2:
Practice Address - City:SUGAR HILL
Practice Address - State:GA
Practice Address - Zip Code:30518-5689
Practice Address - Country:US
Practice Address - Phone:770-831-7507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP005479235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist