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General NPI Number Information
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NPI Number | 1750196473
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Entity Type | Individual
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Provider Name | RACHEL KIRKER BCBA
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Gender | Female
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Dates
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Enumeration Date | 02/10/2025
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Last Update Date | 02/10/2025
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Provider Practice Location Address
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Address Line | 1 SUNSET AVE
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City | VERONA
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State | NJ
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Zip | 07044-5118
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Country | US
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Telephone | 973-509-3050
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Fax |
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Provider Business Mailing Address
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Address Line | 136 FOREST ST
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City | MONTCLAIR
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State | NJ
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Zip | 07042-3806
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Country | US
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Telephone | 862-596-5114
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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 | 1-24-76484
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License Number State | NJ
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