Healthcare Provider Details

I. General information

NPI: 1245973171
Provider Name (Legal Business Name): RACHEL MOORE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: RACHEL LOWE

II. Dates (important events)

Enumeration Date: 04/19/2022
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1053 LOVERS LN
BOWLING GREEN KY
42103-7166
US

IV. Provider business mailing address

90 HOWARD DR
SHELBYVILLE KY
40065-8138
US

V. Phone/Fax

Practice location:
  • Phone: 270-807-0335
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number301812
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: