MEDICARE: RACHEL GRASS

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	1-16-24446	TX

General Provider Information

NPI Number	:	1043756158
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL GRASS

Provider Business Mailing Address
First Line	:	1824 SAWDUST RD STE A
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77380-3667
Country	:	US
Telephone Number	:	972-343-8588
Fax Number	:

Provider Business Practice Location Address
First Line	:	1824 SAWDUST RD STE A
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77380-3667
Country	:	US
Telephone Number	:	972-343-8588
Fax Number	:

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

Provider Enumeration Date	:	01/12/2017
Last Update Date	:	12/08/2021

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Directions to “ RACHEL GRASS ” Practice Location

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