Healthcare Provider Details

I. General information

NPI: 1194491811
Provider Name (Legal Business Name): RACHAEL KATHLEEN CILEK M.ED., BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2021
Last Update Date: 08/22/2021
Certification Date: 08/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5209 DUVAL RD
AUSTIN TX
78727-6614
US

IV. Provider business mailing address

13405 SADDLE BACK PASS
AUSTIN TX
78738-6149
US

V. Phone/Fax

Practice location:
  • Phone: 512-962-5543
  • Fax:
Mailing address:
  • Phone: 512-962-5543
  • Fax: 512-504-3777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number4305
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: