Individual
MRS. RACHEL RUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, BCBA
Contact information
Practice address
2501 CHATHAM RD STE N, SPRINGFIELD, IL 62704-4188
(618) 316-4378
Mailing address
2501 CHATHAM RD STE N, SPRINGFIELD, IL 62704-4188
(618) 316-4378
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103K00000X
Behavior Analyst
Primary
1-23-65505
IL
103K00000X
Behavior Analyst
152.000810
IL
Other
Enumeration date
10/04/2017
Last updated
03/18/2025
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