Healthcare Provider Details

I. General information

NPI: 1518082924
Provider Name (Legal Business Name): RHONDA RIVERS PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 12/13/2021
Certification Date: 12/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3330 CUMBERLAND BLVD SE STE 175
ATLANTA GA
30339-6065
US

IV. Provider business mailing address

3330 CUMBERLAND BLVD SE STE 175
ATLANTA GA
30339-6065
US

V. Phone/Fax

Practice location:
  • Phone: 470-590-5895
  • Fax:
Mailing address:
  • Phone: 470-590-5895
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number2423
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: