Provider Demographics
NPI:1902624141
Name:MULOCK, RACHEL GEBELEIN
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:GEBELEIN
Last Name:MULOCK
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 1:171 ROBERT WHITFIELD RD
Mailing Address - Street 2:
Mailing Address - City:HURDLE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:27541-7895
Mailing Address - Country:US
Mailing Address - Phone:704-792-8148
Mailing Address - Fax:
Practice Address - Street 1:4024 STIRRUP CREEK DR
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-9464
Practice Address - Country:US
Practice Address - Phone:919-767-0278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-27
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA20587101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health