Provider Demographics
NPI:1356664155
Name:DEITERMAN, RHONDA KAY (LPC, LBSW)
Entity Type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:KAY
Last Name:DEITERMAN
Suffix:
Gender:F
Credentials:LPC, LBSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2084 ROSS RD
Mailing Address - Street 2:
Mailing Address - City:ELM MOTT
Mailing Address - State:TX
Mailing Address - Zip Code:76640-3641
Mailing Address - Country:US
Mailing Address - Phone:254-495-1606
Mailing Address - Fax:
Practice Address - Street 1:2084 ROSS RD
Practice Address - Street 2:
Practice Address - City:ELM MOTT
Practice Address - State:TX
Practice Address - Zip Code:76640-3641
Practice Address - Country:US
Practice Address - Phone:254-495-1606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-08
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19647101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor