Provider Demographics
NPI:1598011876
Name:RAPHAELSON, REBECCA NOELLE HUCKABY (MA)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:NOELLE HUCKABY
Last Name:RAPHAELSON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MS
Other - First Name:REBECCA
Other - Middle Name:NOELLE
Other - Last Name:HUCKABY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 40
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81602-0040
Mailing Address - Country:US
Mailing Address - Phone:970-945-2241
Mailing Address - Fax:970-945-5523
Practice Address - Street 1:405 CASTLE CREEK RD
Practice Address - Street 2:STE 9
Practice Address - City:ASPEN
Practice Address - State:CO
Practice Address - Zip Code:81611-3125
Practice Address - Country:US
Practice Address - Phone:970-920-5555
Practice Address - Fax:970-920-5557
Is Sole Proprietor?:No
Enumeration Date:2012-07-24
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health