Provider Demographics
NPI:1962767129
Name:MANUEL, RACHEL JOY (BCBA)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:JOY
Last Name:MANUEL
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 1:6 SAINT LO DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80902-1705
Mailing Address - Country:US
Mailing Address - Phone:254-702-5131
Mailing Address - Fax:
Practice Address - Street 1:1312 17TH ST STE 11
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80202-1508
Practice Address - Country:US
Practice Address - Phone:706-780-1704
Practice Address - Fax:706-780-1705
Is Sole Proprietor?:No
Enumeration Date:2012-07-12
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0-12-5035103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst