Provider Demographics
NPI:1972858090
Name:RICH, AMBER (BCBA)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:RICH
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 REVERE DR
Mailing Address - Street 2:SUITE AA
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-8001
Mailing Address - Country:US
Mailing Address - Phone:847-564-0822
Mailing Address - Fax:847-348-3706
Practice Address - Street 1:85 REVERE DR
Practice Address - Street 2:SUITE AA
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-8001
Practice Address - Country:US
Practice Address - Phone:847-564-0822
Practice Address - Fax:847-348-3706
Is Sole Proprietor?:No
Enumeration Date:2012-07-14
Last Update Date:2012-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst