| Doctor Name: | RAELYNN PEDERSEN |
| NPI Number: | 1194043760 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | 11229 |
| Business Practice Address: | 796 Megan Ste 300 Rifle, CO - 816504703 |
| Business Phone Number: | 9706253582 |
| Business Fax Number: | 9706259707 |
| Mailing Address: | 515 28 3/4 Rd, Bldg A GRAND JUNCTION |
| State: | CO |
| Postal Code: | 815015016 |
| Phone Number: | 9706837107 |
| Fax Number: | 9702553963 |
| NPI Enumeration Date: | 05/06/2010 |
| NPI Last Update Date: | 10/30/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 11229 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |