MEDICARE: RACHEL THOMAS

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-22-239250	CO

General Provider Information

NPI Number	:	1962128645
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL THOMAS

Provider Business Mailing Address
First Line	:	2997 BROADMOOR VALLEY RD
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-4405
Country	:	US
Telephone Number	:	719-203-4723
Fax Number	:

Provider Business Practice Location Address
First Line	:	2997 BROADMOOR VALLEY RD
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-4405
Country	:	US
Telephone Number	:	719-203-4723
Fax Number	:

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

Provider Enumeration Date	:	10/14/2022
Last Update Date	:	10/14/2022

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Directions to “ RACHEL THOMAS ” Practice Location

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