Healthcare Provider Details

I. General information

NPI: 1982116661
Provider Name (Legal Business Name): RHONDA TAYLOR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2017
Last Update Date: 10/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 STOVER DR STE A
DELAWARE OH
43015-8601
US

IV. Provider business mailing address

106 STOVER DR STE A
DELAWARE OH
43015-8601
US

V. Phone/Fax

Practice location:
  • Phone: 740-417-9265
  • Fax:
Mailing address:
  • Phone: 740-417-9265
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.1700759
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE.1901454
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: