Provider Demographics
NPI:1679132658
Name:RAUSCHENBURG, CHANDISS (MS, BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:CHANDISS
Middle Name:
Last Name:RAUSCHENBURG
Suffix:
Gender:F
Credentials:MS, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92-6048 NEMO ST
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-2813
Mailing Address - Country:US
Mailing Address - Phone:808-457-9855
Mailing Address - Fax:
Practice Address - Street 1:2752 WOODLAWN DR STE 5-202
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96822-1855
Practice Address - Country:US
Practice Address - Phone:800-273-4292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-12
Last Update Date:2023-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIRBT-20-142820106S00000X
HI1-22-63337103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician