Healthcare Provider Details

I. General information

NPI: 1871178038
Provider Name (Legal Business Name): RACHEL LECKRONE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2021
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

719 N BRADLEY HWY
ROGERS CITY MI
49779-1512
US

IV. Provider business mailing address

8197 HAKEN RD
ALPENA MI
49707-7724
US

V. Phone/Fax

Practice location:
  • Phone: 888-924-2366
  • Fax:
Mailing address:
  • Phone: 888-924-2366
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: