Provider Demographics
NPI:1629342753
Name:TULLIS, RACHEL (BCBA, PHD)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:
Last Name:TULLIS
Suffix:
Gender:F
Credentials:BCBA, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 MURRAY HILL AVE NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30317-1346
Mailing Address - Country:US
Mailing Address - Phone:954-732-0012
Mailing Address - Fax:
Practice Address - Street 1:927 3RD AVE
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-4832
Practice Address - Country:US
Practice Address - Phone:954-732-0012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-07
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist