Provider Demographics
NPI:1740896778
Name:RAND, CHANA M (BCBA)
Entity type:Individual
Prefix:
First Name:CHANA
Middle Name:M
Last Name:RAND
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 DINSMORE AVE
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-4716
Mailing Address - Country:US
Mailing Address - Phone:917-860-7421
Mailing Address - Fax:
Practice Address - Street 1:1449 37TH ST STE 100
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-4381
Practice Address - Country:US
Practice Address - Phone:718-215-5311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-15
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst