Provider Demographics
NPI:1487986188
Name:KNUDSEN, REBECCA (LMFT)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:
Last Name:KNUDSEN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19501 E MAINSTREET STE 200
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-7408
Mailing Address - Country:US
Mailing Address - Phone:303-886-6092
Mailing Address - Fax:303-954-9854
Practice Address - Street 1:19501 E MAINSTREET STE 200
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-7408
Practice Address - Country:US
Practice Address - Phone:303-886-6092
Practice Address - Fax:303-954-9854
Is Sole Proprietor?:No
Enumeration Date:2010-02-04
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO776106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist