Provider Demographics
NPI:1164776399
Name:DUGAN, RHONDA ANNE
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:ANNE
Last Name:DUGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RHONDA
Other - Middle Name:ANNE
Other - Last Name:FAULKNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:604 N 11TH ST
Mailing Address - Street 2:
Mailing Address - City:HARTSHORNE
Mailing Address - State:OK
Mailing Address - Zip Code:74547-2424
Mailing Address - Country:US
Mailing Address - Phone:918-297-5422
Mailing Address - Fax:
Practice Address - Street 1:604 N 11TH ST
Practice Address - Street 2:
Practice Address - City:HARTSHORNE
Practice Address - State:OK
Practice Address - Zip Code:74547-2424
Practice Address - Country:US
Practice Address - Phone:918-297-5422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-09
Last Update Date:2012-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor