MEDICARE: RHONDA KILDEA MA, MFT, CEDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	0961	NV

General Provider Information

NPI Number	:	1164675294
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RHONDA KILDEA MA, MFT, CEDS

Provider Business Mailing Address
First Line	:	7371 W CHARLESTON BLVD STE 110
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-1575
Country	:	US
Telephone Number	:	702-245-6677
Fax Number	:	702-471-7411

Provider Business Practice Location Address
First Line	:	7371 W CHARLESTON BLVD STE 110
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-1575
Country	:	US
Telephone Number	:	702-245-6677
Fax Number	:	702-471-7411

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/03/2008
Last Update Date	:	11/03/2008

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