MEDICARE: RAEGAN CAMBRON

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	106S00000X	Behavior Technician	RBT-26-523426

General Provider Information

NPI Number	:	1881520864
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAEGAN CAMBRON

Provider Business Mailing Address
First Line	:	PO BOX 931142
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	31193-1142
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2628 RING RD
Second Line	:
City	:	ELIZABETHTOWN
State	:	KY
Zip	:	42701-9118
Country	:	US
Telephone Number	:	270-215-5959
Fax Number	:

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

Provider Enumeration Date	:	06/18/2026
Last Update Date	:	06/18/2026

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Directions to “ RAEGAN CAMBRON ” Practice Location

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