Provider Demographics
NPI:1912163718
Name:HART, REBECCA ASHLEY
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:ASHLEY
Last Name:HART
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 1:20 S BOULDER CIR APT 2102
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-4286
Mailing Address - Country:US
Mailing Address - Phone:303-929-4906
Mailing Address - Fax:
Practice Address - Street 1:5150 ALLISON ST
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80002-4316
Practice Address - Country:US
Practice Address - Phone:303-982-2145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-31
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional