Provider Demographics
NPI:1376184374
Name:ROTARIUS, KIEL (BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:KIEL
Middle Name:
Last Name:ROTARIUS
Suffix:
Gender:M
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5121 NE ELAM YOUNG PKWY STE A
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-8295
Mailing Address - Country:US
Mailing Address - Phone:503-336-5090
Mailing Address - Fax:
Practice Address - Street 1:5121 NE ELAM YOUNG PKWY STE A
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-8295
Practice Address - Country:US
Practice Address - Phone:503-336-5090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-01
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst