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NPI Code Detail

MEDICARE: RACHAEL ELMERS

MEDICARE: RACHAEL ELMERS
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
1103K00000XBehavior Analyst7401002373MI

General Provider Information

NPI Number : 1780432088
Entity Type Code : Individual
Provider Name (Legal Business Name) : RACHAEL ELMERS
Provider Business Mailing Address
First Line : 1126 EQUESTRIAN DR
Second Line :
City : SOUTH LYON
State : MI
Zip : 48178-5306
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 30701 BARRINGTON ST STE 150
Second Line :
City : MADISON HEIGHTS
State : MI
Zip : 48071-5135
Country : US
Telephone Number : 248-965-3916
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2024
Last Update Date : 05/10/2024

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