Provider Demographics
NPI:1376798611
Name:RATTENBORG, BARBARA ANN (LISW)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANN
Last Name:RATTENBORG
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 173
Mailing Address - Street 2:VALENCIA COUNSELING
Mailing Address - City:ESTANCIA
Mailing Address - State:NM
Mailing Address - Zip Code:87016
Mailing Address - Country:US
Mailing Address - Phone:505-384-0220
Mailing Address - Fax:505-384-0222
Practice Address - Street 1:1011 ALLEN
Practice Address - Street 2:VALENCIA COUNSELING
Practice Address - City:ESTANCIA
Practice Address - State:NM
Practice Address - Zip Code:87016
Practice Address - Country:US
Practice Address - Phone:505-384-0220
Practice Address - Fax:505-384-0222
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-01
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMI-06767101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health