Individual
RACHEL A SHABAZZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
127 NEW ST, WAVERLY, VA 23890-5006
(804) 898-9258
Mailing address
1100 SLATEWORTH DR APT 1123, DURHAM, NC 27703-6211
(804) 898-9258
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1261011229
VA
246Z00000X
Other Specialist/Technologist
1261011229
VA
Other
Enumeration date
07/14/2025
Last updated
07/14/2025
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