Provider Demographics
NPI:1043991227
Name:POWERS, RACHAEL V (MA, BCBA, LABA)
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:V
Last Name:POWERS
Suffix:
Gender:F
Credentials:MA, BCBA, LABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 WINNECUNNET WAY
Mailing Address - Street 2:
Mailing Address - City:SOUTH EASTON
Mailing Address - State:MA
Mailing Address - Zip Code:02375-1464
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:95 EASTERN AVE STE 8
Practice Address - Street 2:
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-4582
Practice Address - Country:US
Practice Address - Phone:617-996-1210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-22-61770103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-22-61770OtherBOARD CERTIFIED BEHAVIOR ANALYST
MALABA10000140OtherBOARD OF REGISTRATION OF ALLIED MENTAL HEALTH AND HUMAN SERVICES PROFESSIONALS