Provider Demographics
NPI:1790072213
Name:D'AMORA, RACHEL (BCABA)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:D'AMORA
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:817 BLACKSTONE VLG
Mailing Address - Street 2:
Mailing Address - City:MERIDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06450-2417
Mailing Address - Country:US
Mailing Address - Phone:203-641-5281
Mailing Address - Fax:
Practice Address - Street 1:817 BLACKSTONE VLG
Practice Address - Street 2:
Practice Address - City:MERIDEN
Practice Address - State:CT
Practice Address - Zip Code:06450-2417
Practice Address - Country:US
Practice Address - Phone:203-641-5281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-05
Last Update Date:2011-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0114140103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst