Provider Demographics
NPI:1740597095
Name:KRAMER, RACHEL (BACB)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:KRAMER
Suffix:
Gender:F
Credentials:BACB
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:KOELKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1300 W LANCASTER AVE
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76102-3410
Mailing Address - Country:US
Mailing Address - Phone:817-390-2884
Mailing Address - Fax:
Practice Address - Street 1:1300 W LANCASTER AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76102-3410
Practice Address - Country:US
Practice Address - Phone:817-336-8611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-08
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-10-6951174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1-10-6951OtherBEHAVIOR ANALYST CERTIFICATION BOARD