MEDICARE: RHONDA LYNN PATTERSON

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	101YS0200X	School Counselor	1614317	IN

General Provider Information

NPI Number	:	1982005385
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RHONDA LYNN PATTERSON

Provider Business Mailing Address
First Line	:	715 N 300 W
Second Line	:
City	:	COLUMBIA CITY
State	:	IN
Zip	:	46725-9154
Country	:	US
Telephone Number	:	260-610-1911
Fax Number	:

Provider Business Practice Location Address
First Line	:	715 N 300 W
Second Line	:
City	:	COLUMBIA CITY
State	:	IN
Zip	:	46725-9154
Country	:	US
Telephone Number	:	260-610-1911
Fax Number	:

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

Provider Enumeration Date	:	09/04/2014
Last Update Date	:	09/04/2014

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