Provider Demographics
NPI:1447234810
Name:RHODES, CHANDELLE LEE (OT)
Entity Type:Individual
Prefix:MRS
First Name:CHANDELLE
Middle Name:LEE
Last Name:RHODES
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20528 LAGOONA DR
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-7110
Mailing Address - Country:US
Mailing Address - Phone:704-378-7379
Mailing Address - Fax:
Practice Address - Street 1:2826 RANDOLPH RD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-1019
Practice Address - Country:US
Practice Address - Phone:704-366-5521
Practice Address - Fax:704-364-3953
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0736225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand