| Organization Name: | REBECCA JANE KNOWLES |
| NPI Number: | 1255639332 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | REBECCA JANE KNOWLES (SOLE PROPRIETOR) |
| Mailing Address: | 204 Autumn Sage Ln Chaparral |
| State: | NM US |
| Postal Code: | 880817732 |
| Phone Number: | 5758244388 |
| Fax Number: | 5758240521 |
| NPI Enumeration Date: | 03/14/2011 |
| NPI Last Update Date: | 03/14/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 0080801 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |