Healthcare Provider Details

I. General information

NPI: 1114842747
Provider Name (Legal Business Name): RHONDA LINN MONTAVON MSED
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404 W SUPERIOR ST STE 210
DULUTH MN
55802-1569
US

IV. Provider business mailing address

3212 CUMMING AVE
SUPERIOR WI
54880-5530
US

V. Phone/Fax

Practice location:
  • Phone: 218-302-4866
  • Fax:
Mailing address:
  • Phone: 218-302-4866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: