Provider Demographics
NPI:1427193283
Name:HEBERLE, RACHEL
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:HEBERLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 S BRADDOCK ST
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-4043
Mailing Address - Country:US
Mailing Address - Phone:540-662-8368
Mailing Address - Fax:
Practice Address - Street 1:120 DOGWOOD DR
Practice Address - Street 2:
Practice Address - City:CROSS JUNCTION
Practice Address - State:VA
Practice Address - Zip Code:22625-2501
Practice Address - Country:US
Practice Address - Phone:540-888-4368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003920101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health