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Individual

RACHEL JILLIAN HENRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RBT

Contact information

Practice address
228 EMMANUEL WAY LN, WEBSTER, KY 40176-5037
(310) 560-9270
Mailing address
228 EMMANUEL WAY LN, WEBSTER, KY 40176-5037

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1306394291
N/A
Enumeration date
01/06/2021
Last updated
01/06/2021
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