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General NPI Number Information
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NPI Number | 1780231167
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Entity Type | Individual
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Provider Name | RACHEL STANGO BCBA, LBS
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Gender | Female
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Dates
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Enumeration Date | 08/21/2019
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Last Update Date | 01/12/2024
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Provider Practice Location Address
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Address Line | 54 MYRTLE ST
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City | BELMONT
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State | NC
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Zip | 28012-5200
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Country | US
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Telephone | 484-222-8691
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Fax |
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Provider Business Mailing Address
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Address Line | 8748 STARDUST LN
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City | PHILADELPHIA
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State | PA
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Zip | 19136-1220
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Country | US
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Telephone | 484-222-8691
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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 | 1-19-35926
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License Number State | PA
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