MEDICARE: RACHEL IGOU

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1649899402
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL IGOU

Provider Business Mailing Address
First Line	:	15 S 15TH ST APT 2A
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23219-4261
Country	:	US
Telephone Number	:	804-517-8594
Fax Number	:

Provider Business Practice Location Address
First Line	:	9201 ARBORETUM PKWY STE 160
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23236-5402
Country	:	US
Telephone Number	:	804-912-1338
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2020
Last Update Date	:	04/13/2020

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Directions to “ RACHEL IGOU ” Practice Location

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