Healthcare Provider Details

I. General information

NPI: 1679130033
Provider Name (Legal Business Name): RACHAEL LYNNE ERICKSON BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2019
Last Update Date: 03/22/2022
Certification Date: 03/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8000 S LINCOLN ST STE 10
LITTLETON CO
80122-2725
US

IV. Provider business mailing address

8000 S LINCOLN ST STE 10
LITTLETON CO
80122-2725
US

V. Phone/Fax

Practice location:
  • Phone: 720-319-7614
  • Fax:
Mailing address:
  • Phone: 720-319-7614
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-17-32754
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-21-56303
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: