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NPI 1316199755

NPI 1316199755 : LISA RHODES LCSW : MONTEVALLO, AL

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General NPI Number Information
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    NPI Number           |    1316199755
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    Entity Type          |    Individual 
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    Provider Name        |    LISA RHODES LCSW
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/16/2008
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    Last Update Date     |    01/02/2012
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Provider Practice Location Address
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    Address Line         |    731 MIDDLE ST 
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    City                 |    MONTEVALLO
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    State                |    AL
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    Zip                  |    35115-3730
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    Country              |    US
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    Telephone            |    205-999-3073
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 82 
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    City                 |    MONTEVALLO
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    State                |    AL
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    Zip                  |    35115-0082
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    Country              |    US
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    Telephone            |    205-999-3073
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    104100000X
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    Taxonomy Name        |    Social Worker
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    License Number       |    1153C
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    License Number State |    AL
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