Provider Demographics
NPI:1306116595
Name:RAZUMNY, REBECCA L (BCBA)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:L
Last Name:RAZUMNY
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:LYNN
Other - Last Name:CORSAIR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:277 MAIN ST STE 308
Mailing Address - Street 2:
Mailing Address - City:MARLBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01752-5520
Mailing Address - Country:US
Mailing Address - Phone:508-485-5300
Mailing Address - Fax:508-485-5353
Practice Address - Street 1:277 MAIN ST STE 308
Practice Address - Street 2:
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-5520
Practice Address - Country:US
Practice Address - Phone:508-485-5300
Practice Address - Fax:508-485-5353
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1-14-17408103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst