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General NPI Number Information
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NPI Number | 1912922832
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Entity Type | Individual
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Provider Name | HEATHER A. RHODES M.S.
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Gender | Female
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 10/21/2024
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Provider Practice Location Address
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Address Line | 1200 S POKEGAMA AVE STE 160
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City | GRAND RAPIDS
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State | MN
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Zip | 55744-4296
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Country | US
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Telephone | 218-327-0887
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 607
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City | COLERAINE
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State | MN
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Zip | 55722-0607
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Country | US
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Telephone |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LP3017
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | LP3017
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | LP3017
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License Number State | MN
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Taxonomy #4
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | LP3017
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License Number State | MN
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