Provider Demographics
NPI:1659006724
Name:RAFFEL, BARBARA ANNE
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANNE
Last Name:RAFFEL
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 1:135 PENDLETON PL
Mailing Address - Street 2:
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-2858
Mailing Address - Country:US
Mailing Address - Phone:732-816-8665
Mailing Address - Fax:
Practice Address - Street 1:160 CONOVER ROAD
Practice Address - Street 2:
Practice Address - City:WICKATUNK
Practice Address - State:NJ
Practice Address - Zip Code:07765
Practice Address - Country:US
Practice Address - Phone:732-816-8665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC00200200104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker