Healthcare Provider Details

I. General information

NPI: 1487135471
Provider Name (Legal Business Name): RACHEL L AMAYA BCBA, LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2018
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6320 PENN AVE S
RICHFIELD MN
55423-1139
US

IV. Provider business mailing address

1920 3RD AVE S
PAYETTE ID
83661-3012
US

V. Phone/Fax

Practice location:
  • Phone: 612-767-7222
  • Fax:
Mailing address:
  • Phone: 541-709-8172
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: