Provider Demographics
NPI:1174655294
Name:NITSCHELM, RHONDA K (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:K
Last Name:NITSCHELM
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:979 RHODES DRAW
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-7061
Mailing Address - Country:US
Mailing Address - Phone:406-755-4558
Mailing Address - Fax:406-755-4458
Practice Address - Street 1:979 RHODES DRAW
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-7061
Practice Address - Country:US
Practice Address - Phone:406-755-4558
Practice Address - Fax:406-755-4458
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD235Z00000X
MT1173235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD5832852Medicaid