Provider Demographics
NPI:1295984417
Name:RABER, LINDA KAY (MFCC CA LIC # 20028)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:KAY
Last Name:RABER
Suffix:
Gender:F
Credentials:MFCC CA LIC # 20028
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 S ARIZONA AVE
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86303-4403
Mailing Address - Country:US
Mailing Address - Phone:928-308-6484
Mailing Address - Fax:
Practice Address - Street 1:769 W BLAINE ST STE B
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92507-3970
Practice Address - Country:US
Practice Address - Phone:951-358-4523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-11
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMS20028106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist