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General NPI Number Information
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NPI Number | 1770517989
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Entity Type | Individual
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Provider Name | BRETT LOWELL RHODEN MA
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Gender | Male
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 01/07/2022
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Provider Practice Location Address
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Address Line | 8382 BAYMEADOWS RD STE 1
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City | JACKSONVILLE
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State | FL
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Zip | 32256-7436
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Country | US
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Telephone | 904-699-8796
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Fax | 904-886-4646
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Provider Business Mailing Address
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Address Line | 8382 BAYMEADOWS RD STE 1
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City | JACKSONVILLE
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State | FL
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Zip | 32256-7436
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Country | US
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Telephone | 904-699-8796
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Fax | 904-880-4060
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MT 0905
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License Number State | FL
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