Provider Demographics
NPI:1093367286
Name:SCHACHTER, ANN RACHEL (BCBA)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:RACHEL
Last Name:SCHACHTER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:CHANA
Other - Middle Name:ROCHEL
Other - Last Name:SCHACHTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BCBA
Mailing Address - Street 1:4411 MINNETONKA BLVD
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55416-5407
Mailing Address - Country:US
Mailing Address - Phone:410-484-9562
Mailing Address - Fax:
Practice Address - Street 1:4411 MINNETONKA BLVD
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55416-5407
Practice Address - Country:US
Practice Address - Phone:410-484-9562
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-09
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLBA638103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst