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NPI Code Detail

MEDICARE: RODNEY PAUL SHRADER

MEDICARE: RODNEY PAUL SHRADER
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
1103TC1900XCounseling PsychologistTN

General Provider Information

NPI Number : 1528884228
Entity Type Code : Individual
Provider Name (Legal Business Name) : RODNEY PAUL SHRADER
Provider Business Mailing Address
First Line : 806 CLOVER LN
Second Line :
City : MANCHESTER
State : TN
Zip : 37355-2377
Country : US
Telephone Number : 931-723-0380
Fax Number :
Provider Business Practice Location Address
First Line : 806 CLOVER LN
Second Line :
City : MANCHESTER
State : TN
Zip : 37355-2377
Country : US
Telephone Number : 931-723-0380
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/26/2024
Last Update Date : 11/26/2024

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Directions to “ RODNEY PAUL SHRADER ” Practice Location

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