MEDICARE: RACHELL AMANDA BALDWIN BCBA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	BHV-010480	TX

General Provider Information

NPI Number	:	1033816517
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHELL AMANDA BALDWIN BCBA

Provider Business Mailing Address
First Line	:	1704 ASPEN SILVER
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78245-4740
Country	:	US
Telephone Number	:	904-703-6843
Fax Number	:

Provider Business Practice Location Address
First Line	:	1704 ASPEN SILVER
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78245-4740
Country	:	US
Telephone Number	:	904-703-6843
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/14/2023
Last Update Date	:	06/16/2026

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