Doctor Name: | JULIE MARIE RABORN |
NPI Number: | 1003162355 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 0146461 |
Business Practice Address: | 600 1st St Nw Suite 200 Albuquerque, NM - 871022311 |
Business Phone Number: | 5052249124 |
Business Fax Number: | 5058479503 |
Mailing Address: | 600 1st St Nw, Suite 200 ALBUQUERQUE |
State: | NM |
Postal Code: | 871022311 |
Phone Number: | 5052249124 |
Fax Number: | |
NPI Enumeration Date: | 07/24/2012 |
NPI Last Update Date: | 07/24/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 0146461 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |