Healthcare Provider Details

I. General information

NPI: 1639813397
Provider Name (Legal Business Name): RACHEL PENN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2022
Last Update Date: 01/02/2026
Certification Date: 01/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2312 SECANE RD
SECANE PA
19018-2810
US

IV. Provider business mailing address

2200 12TH CT N APT 511
ARLINGTON VA
22201-6513
US

V. Phone/Fax

Practice location:
  • Phone: 267-564-5717
  • Fax:
Mailing address:
  • Phone: 914-708-7376
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: