Provider Demographics
NPI:1386509099
Name:CHAMBERLAIN, RACHEL DIANA
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:DIANA
Last Name:CHAMBERLAIN
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 1:2220 H G MOSLEY PKWY
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75604-3663
Mailing Address - Country:US
Mailing Address - Phone:903-353-9247
Mailing Address - Fax:317-334-7336
Practice Address - Street 1:2220 H G MOSLEY PKWY
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75604-3663
Practice Address - Country:US
Practice Address - Phone:903-353-9247
Practice Address - Fax:317-334-7336
Is Sole Proprietor?:No
Enumeration Date:2025-12-16
Last Update Date:2025-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRBT-25-430486106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician