=====================================================
General NPI Number Information
=====================================================
NPI Number | 1003769514
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RACHEL LEE WAYBRANT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/16/2026
-----------------------------------------------------
Last Update Date | 02/16/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2650 I 75 BUSINESS SPUR
-----------------------------------------------------
City | SAULT SAINTE MARIE
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49783-3536
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 231-268-0007
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6425 N 3 MILE RD
-----------------------------------------------------
City | PICKFORD
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49774-9043
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 906-322-6489
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106S00000X
-----------------------------------------------------
Taxonomy Name | Behavior Technician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------