MEDICARE: RHONDA WARE-REDDEN LLMFT

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	4151001050	MI

General Provider Information

NPI Number	:	1992453286
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RHONDA WARE-REDDEN LLMFT

Provider Business Mailing Address
First Line	:	23689 WHITLEY DR
Second Line	:
City	:	CLINTON TOWNSHIP
State	:	MI
Zip	:	48035-4638
Country	:	US
Telephone Number	:	313-310-9345
Fax Number	:

Provider Business Practice Location Address
First Line	:	42815 GARFIELD RD STE 201
Second Line	:
City	:	CLINTON TWP
State	:	MI
Zip	:	48038-1143
Country	:	US
Telephone Number	:	586-333-5328
Fax Number	:	586-948-9304

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

Provider Enumeration Date	:	03/15/2022
Last Update Date	:	03/15/2022

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