Healthcare Provider Details

I. General information

NPI: 1225978927
Provider Name (Legal Business Name): RHONDA MAJOR MACK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1096 ASHCRAFT AVE
BLACKLICK OH
43004-7038
US

IV. Provider business mailing address

1096 ASHCRAFT AVE
BLACKLICK OH
43004-7038
US

V. Phone/Fax

Practice location:
  • Phone: 614-530-2472
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: