MEDICARE: DR. JENNIFER P. RHODES PH.D.

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	103TC1900X	Counseling Psychologist	1114	AZ

General Provider Information

NPI Number	:	1417907767
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIFER P. RHODES PH.D.

Provider Business Mailing Address
First Line	:	PO BOX 8806
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85738-0806
Country	:	US
Telephone Number	:	480-449-9070
Fax Number	:	480-449-9072

Provider Business Practice Location Address
First Line	:	15601 N ORACLE RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85739-9111
Country	:	US
Telephone Number	:	480-221-5099
Fax Number	:	406-552-4858

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

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	01/29/2018

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