Provider Demographics
NPI:1417907767
Name:RHODES, JENNIFER P (PHD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:P
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:PO BOX 8806
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85738-0806
Mailing Address - Country:US
Mailing Address - Phone:480-449-9070
Mailing Address - Fax:480-449-9072
Practice Address - Street 1:15601 N ORACLE RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85739-9111
Practice Address - Country:US
Practice Address - Phone:480-221-5099
Practice Address - Fax:406-552-4858
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2018-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1114103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ65626Medicare ID - Type Unspecified