Provider Demographics
NPI:1790284917
Name:KENT, RACHEL A
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:A
Last Name:KENT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 SHANLEY CT
Mailing Address - Street 2:
Mailing Address - City:CROMWELL
Mailing Address - State:CT
Mailing Address - Zip Code:06416-1606
Mailing Address - Country:US
Mailing Address - Phone:860-705-1660
Mailing Address - Fax:
Practice Address - Street 1:5 SHANLEY CT
Practice Address - Street 2:
Practice Address - City:CROMWELL
Practice Address - State:CT
Practice Address - Zip Code:06416-1606
Practice Address - Country:US
Practice Address - Phone:860-705-1660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-02
Last Update Date:2018-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst