Provider Demographics
NPI:1235403486
Name:DELGADO, RACHEL (MSED, BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:DELGADO
Suffix:
Gender:F
Credentials:MSED, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7108 S KANNER HWY
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34997-7462
Mailing Address - Country:US
Mailing Address - Phone:855-832-6727
Mailing Address - Fax:
Practice Address - Street 1:5563 REDLEAF ROSE DR
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29579-4478
Practice Address - Country:US
Practice Address - Phone:855-832-6727
Practice Address - Fax:772-675-9100
Is Sole Proprietor?:No
Enumeration Date:2012-03-06
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1-12-10047103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA090063594OtherCALIFORNIA COMMISSION ON TEACHER CREDENTIALING
NY000453OtherNYSED OFFICE OF THE PROFESSIONS
VA0133002835OtherVIRGINIA DEPARTMENT OF HEALTH PROFESSIONS
NY837552OtherNYS BOARD OF EDUCATION
NY1-12-10047OtherBACB