Provider Demographics
NPI:1346779964
Name:WARD, RODNEY LEE
Entity Type:Individual
Prefix:MR
First Name:RODNEY
Middle Name:LEE
Last Name:WARD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 BOXWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-9457
Mailing Address - Country:US
Mailing Address - Phone:318-355-3809
Mailing Address - Fax:
Practice Address - Street 1:102 BOXWOOD DR
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-9457
Practice Address - Country:US
Practice Address - Phone:318-355-3809
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician