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NPI Code Detail

MEDICARE: JESSICA ANNE RHOADS LPC

MEDICARE: JESSICA ANNE RHOADS 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 Counselor4448OK

General Provider Information

NPI Number : 1992826663
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA ANNE RHOADS LPC
Provider Business Mailing Address
First Line : 2108 MELROSE DR
Second Line :
City : PONCA CITY
State : OK
Zip : 74604-2411
Country : US
Telephone Number : 580-765-2430
Fax Number :
Provider Business Practice Location Address
First Line : 6501 NE 50TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73141-9118
Country : US
Telephone Number : 405-605-5936
Fax Number : 405-605-5919
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/02/2007
Last Update Date : 04/27/2011

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Directions to “ JESSICA ANNE RHOADS LPC” Practice Location

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