Provider Demographics
NPI:1568726560
Name:MASTRANGELO, RACHEL ANN (MSED, BCBA, LABA)
Entity Type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:ANN
Last Name:MASTRANGELO
Suffix:
Gender:F
Credentials:MSED, BCBA, LABA
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:ANN
Other - Last Name:JACKSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSED, BCBA
Mailing Address - Street 1:85 MAIN ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WATERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02472-4411
Mailing Address - Country:US
Mailing Address - Phone:617-923-7575
Mailing Address - Fax:
Practice Address - Street 1:85 MAIN ST
Practice Address - Street 2:SUITE 102
Practice Address - City:WATERTOWN
Practice Address - State:MA
Practice Address - Zip Code:02472-4411
Practice Address - Country:US
Practice Address - Phone:617-923-7575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-25
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst