Healthcare Provider Details

I. General information

NPI: 1245531409
Provider Name (Legal Business Name): RACHEL NOELLE KOLB LPA, LBA, BCBA, M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2010
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5121 KINGDOM WAY STE 100
RALEIGH NC
27607-6063
US

IV. Provider business mailing address

5121 KINGDOM WAY STE 100
RALEIGH NC
27607-6063
US

V. Phone/Fax

Practice location:
  • Phone: 919-865-5077
  • Fax:
Mailing address:
  • Phone: 919-865-5077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number4114
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1107733
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: