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NPI Code Detail

MEDICARE: RACHEL DIVERDI

MEDICARE: RACHEL DIVERDI
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
1106S00000XBehavior Technician
2103K00000XBehavior Analyst

General Provider Information

NPI Number : 1588157325
Entity Type Code : Individual
Provider Name (Legal Business Name) : RACHEL DIVERDI
Provider Business Mailing Address
First Line : 177 MAIN ST APT B4
Second Line :
City : NORTHPORT
State : NY
Zip : 11768-1729
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 85 CHAPEL ST
Second Line :
City : NEWTON
State : MA
Zip : 02458-1065
Country : US
Telephone Number : 508-363-0200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2018
Last Update Date : 04/08/2021

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Directions to “ RACHEL DIVERDI ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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