Provider Demographics
NPI:1417706789
Name:KREISMAN, RACHEL (BCBA)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:KREISMAN
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 E 8TH ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-1902
Mailing Address - Country:US
Mailing Address - Phone:848-261-9535
Mailing Address - Fax:
Practice Address - Street 1:21 E 8TH ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-1902
Practice Address - Country:US
Practice Address - Phone:848-261-9535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-17
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst