Provider Demographics
NPI:1598153538
Name:ST. AUBIN, RAQUEL
Entity Type:Individual
Prefix:
First Name:RAQUEL
Middle Name:
Last Name:ST. AUBIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RAQUEL
Other - Middle Name:
Other - Last Name:SIMONS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6000 E EVANS AVE
Mailing Address - Street 2:3-100
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-5406
Mailing Address - Country:US
Mailing Address - Phone:720-940-8531
Mailing Address - Fax:720-378-5034
Practice Address - Street 1:6000 E EVANS AVE
Practice Address - Street 2:3-100
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-5406
Practice Address - Country:US
Practice Address - Phone:720-940-8531
Practice Address - Fax:720-378-5034
Is Sole Proprietor?:No
Enumeration Date:2014-12-29
Last Update Date:2014-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.000010421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical