Provider Demographics
NPI:1750841805
Name:CHANEY, REBEKAH (BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:
Last Name:CHANEY
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12423 NE 131ST CT APT E303
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-7428
Mailing Address - Country:US
Mailing Address - Phone:425-543-8728
Mailing Address - Fax:
Practice Address - Street 1:12423 NE 131ST CT APT E303
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-7428
Practice Address - Country:US
Practice Address - Phone:425-543-8728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-24
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WABA61046800103K00000X
WA1-20-40919103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst