Provider Demographics
NPI:1346974789
Name:RHODES, JESSICA DEE (PHD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:DEE
Last Name:RHODES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 GATEWAY RD
Mailing Address - Street 2:
Mailing Address - City:NEW WILMINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:16142-1351
Mailing Address - Country:US
Mailing Address - Phone:607-425-5454
Mailing Address - Fax:
Practice Address - Street 1:2703 W STATE ST
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16101-8645
Practice Address - Country:US
Practice Address - Phone:724-657-3303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-12
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS019622103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical