Healthcare Provider Details

I. General information

NPI: 1639499163
Provider Name (Legal Business Name): RHONDA LYNN RHUDY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2010
Last Update Date: 03/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2333 N 6TH ST
GRAND JUNCTION CO
81501-2001
US

IV. Provider business mailing address

2333 N 6TH ST
GRAND JUNCTION CO
81501-2001
US

V. Phone/Fax

Practice location:
  • Phone: 970-298-1782
  • Fax: 970-298-1726
Mailing address:
  • Phone: 970-298-1782
  • Fax: 970-298-1726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number991507
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: