Provider Demographics
NPI:1689998973
Name:SOUZA, RACHEL CAROLYN (MA, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:CAROLYN
Last Name:SOUZA
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8122 FOREVER GREEN CT
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-6477
Mailing Address - Country:US
Mailing Address - Phone:410-804-4811
Mailing Address - Fax:
Practice Address - Street 1:8122 FOREVER GREEN CT
Practice Address - Street 2:
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-6477
Practice Address - Country:US
Practice Address - Phone:410-804-4811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-16
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLBA056103K00000X
FL1-09-6673103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst