Provider Demographics
NPI:1881166551
Name:BUCKLEY, RACHAEL ELLEN (BCBA)
Entity type:Individual
Prefix:MISS
First Name:RACHAEL
Middle Name:ELLEN
Last Name:BUCKLEY
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3156 BOSTON RD
Mailing Address - Street 2:
Mailing Address - City:WILBRAHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01095-1805
Mailing Address - Country:US
Mailing Address - Phone:413-636-4906
Mailing Address - Fax:
Practice Address - Street 1:1 FEDERAL STREET
Practice Address - Street 2:STCCAC TECHNICAL PARK, BUILDING 101, 1 EAST-3
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01105
Practice Address - Country:US
Practice Address - Phone:413-237-0964
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-19
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst