Provider Demographics
NPI:1851420236
Name:REYBURN, DENISE D (MED, LMHC, NCC, DCC)
Entity Type:Individual
Prefix:MS
First Name:DENISE
Middle Name:D
Last Name:REYBURN
Suffix:
Gender:F
Credentials:MED, LMHC, NCC, DCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1290 RAVEN CREEK DR NW
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98311-9042
Mailing Address - Country:US
Mailing Address - Phone:360-649-0603
Mailing Address - Fax:360-692-5340
Practice Address - Street 1:1290 RAVEN CREEK DR NW
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98311-9042
Practice Address - Country:US
Practice Address - Phone:360-649-0603
Practice Address - Fax:360-692-5340
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00003638101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health