Healthcare Provider Details

I. General information

NPI: 1346819331
Provider Name (Legal Business Name): RACHEL GAUSE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2021
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7007 DEXTER ANN ARBOR RD
DEXTER MI
48130-8568
US

IV. Provider business mailing address

7007 DEXTER ANN ARBOR RD
DEXTER MI
48130-8568
US

V. Phone/Fax

Practice location:
  • Phone: 734-985-2335
  • Fax: 734-418-0794
Mailing address:
  • Phone: 734-985-2335
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number7401002945
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: