Provider Demographics
NPI:1902532682
Name:BISHOP, RACHEL EMMA
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:EMMA
Last Name:BISHOP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 WILLOWBROOK RD
Mailing Address - Street 2:
Mailing Address - City:QUEENSBURY
Mailing Address - State:NY
Mailing Address - Zip Code:12804-5882
Mailing Address - Country:US
Mailing Address - Phone:518-926-7100
Mailing Address - Fax:518-563-9001
Practice Address - Street 1:25 WILLOWBROOK RD
Practice Address - Street 2:
Practice Address - City:QUEENSBURY
Practice Address - State:NY
Practice Address - Zip Code:12804-5882
Practice Address - Country:US
Practice Address - Phone:518-926-7100
Practice Address - Fax:518-563-9001
Is Sole Proprietor?:No
Enumeration Date:2022-07-26
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician