Provider Demographics
NPI:1144457573
Name:RABCZAK, GRETEL ANELIS (LMHC)
Entity type:Individual
Prefix:MRS
First Name:GRETEL
Middle Name:ANELIS
Last Name:RABCZAK
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20801 BISCAYNE BLVD STE 403
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1423
Mailing Address - Country:US
Mailing Address - Phone:786-897-0276
Mailing Address - Fax:305-931-0124
Practice Address - Street 1:20801 BISCAYNE BLVD STE 403
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1423
Practice Address - Country:US
Practice Address - Phone:786-897-0276
Practice Address - Fax:305-931-0124
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-11
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL7818101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health