Provider Demographics
NPI:1164931820
Name:DOVIN, RACHEL (BCBA)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:DOVIN
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 RED CYPRESS RUN
Mailing Address - Street 2:
Mailing Address - City:MIDLAND CITY
Mailing Address - State:AL
Mailing Address - Zip Code:36350-0020
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9917 W ANTIETAM ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83709-3405
Practice Address - Country:US
Practice Address - Phone:850-797-8280
Practice Address - Fax:208-600-6055
Is Sole Proprietor?:No
Enumeration Date:2017-09-26
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0-17-8031103K00000X
AL1-22-60215103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst