Healthcare Provider Details
I. General information
NPI: 1790494474
Provider Name (Legal Business Name): RHODA T BRITTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/21/2022
Last Update Date: 11/21/2022
Certification Date: 11/21/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2807 EVANGELINE ST
MONROE LA
71201-3749
US
IV. Provider business mailing address
2900 CAMERON ST
MONROE LA
71201-3714
US
V. Phone/Fax
- Phone: 318-654-7667
- Fax: 318-816-5923
- Phone: 318-323-9995
- Fax: 318-816-5923
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171M00000X |
| Taxonomy | Case Manager/Care Coordinator |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: