Provider Demographics
NPI:1669226197
Name:RAWLES, CHARLEIGH D (MS CF-SLP)
Entity type:Individual
Prefix:
First Name:CHARLEIGH
Middle Name:D
Last Name:RAWLES
Suffix:
Gender:F
Credentials:MS CF-SLP
Other - Prefix:
Other - First Name:CHARLEIGH
Other - Middle Name:DANYEL
Other - Last Name:RAWLES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2814 ESTELLA WAY
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23325-4778
Mailing Address - Country:US
Mailing Address - Phone:757-582-8468
Mailing Address - Fax:
Practice Address - Street 1:3509 VIRGINIA BEACH BLVD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-4421
Practice Address - Country:US
Practice Address - Phone:757-261-4475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-12
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2204001309235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist