Provider Demographics
NPI:1124530373
Name:THEYS, RACHEL (MSED, BCBA, LABA)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:THEYS
Suffix:
Gender:F
Credentials:MSED, BCBA, LABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 LIBERTY ST STE 13A
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-7511
Mailing Address - Country:US
Mailing Address - Phone:617-957-6451
Mailing Address - Fax:508-857-5893
Practice Address - Street 1:130 LIBERTY ST STE 13A
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301
Practice Address - Country:US
Practice Address - Phone:617-957-6451
Practice Address - Fax:508-857-5893
Is Sole Proprietor?:No
Enumeration Date:2017-10-27
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA000001867103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst