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General NPI Number Information
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NPI Number | 1427728757
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Entity Type | Individual
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Provider Name | RACHEL MARIE WOZNIAK BCBA
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Gender | Female
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Dates
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Enumeration Date | 09/17/2021
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Last Update Date | 09/17/2021
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Provider Practice Location Address
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Address Line | 986 LAKEVIEW DR
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City | GREEN BAY
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State | WI
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Zip | 54313-8818
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Country | US
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Telephone | 920-600-9129
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Fax |
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Provider Business Mailing Address
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Address Line | 3862 CHAMPEAU RD
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City | NEW FRANKEN
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State | WI
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Zip | 54229-9730
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Country | US
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Telephone | 920-265-5833
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-21-53190
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License Number State | WI
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