Provider Demographics
NPI:1104603737
Name:RABEN, JULIA ANN
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:ANN
Last Name:RABEN
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 1:300 SHELTON ST
Mailing Address - Street 2:
Mailing Address - City:CHADRON
Mailing Address - State:NE
Mailing Address - Zip Code:69337-2312
Mailing Address - Country:US
Mailing Address - Phone:308-432-8979
Mailing Address - Fax:308-432-8974
Practice Address - Street 1:4200 ELKHORN ST
Practice Address - Street 2:
Practice Address - City:WHITNEY
Practice Address - State:NE
Practice Address - Zip Code:69367-9502
Practice Address - Country:US
Practice Address - Phone:308-207-5125
Practice Address - Fax:855-551-4086
Is Sole Proprietor?:No
Enumeration Date:2023-09-08
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD21054101YM0800X
NE14115101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health