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NPI Code Detail

MEDICARE: MRS. SANDRA SUE RAHM LPC

MEDICARE: MRS. SANDRA SUE RAHM LPC
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
1101YP2500XProfessional Counselor001772MO

General Provider Information

NPI Number : 1386972685
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SANDRA SUE RAHM LPC
Provider Business Mailing Address
First Line : 413 E SPRING ST
Second Line :
City : BOONVILLE
State : MO
Zip : 65233-1573
Country : US
Telephone Number : 660-882-6400
Fax Number : 660-882-7137
Provider Business Practice Location Address
First Line : 413 E SPRING ST
Second Line :
City : BOONVILLE
State : MO
Zip : 65233-1573
Country : US
Telephone Number : 660-882-6400
Fax Number : 660-882-7137
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/24/2009
Last Update Date : 11/24/2009

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