Provider Demographics
NPI:1477841849
Name:RHONDA THOMAS-MORALDO
Entity Type:Organization
Organization Name:RHONDA THOMAS-MORALDO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS-MORALDO
Authorized Official - Suffix:
Authorized Official - Credentials:BHRS
Authorized Official - Phone:405-503-3296
Mailing Address - Street 1:PO BOX 7940
Mailing Address - Street 2:
Mailing Address - City:MOORE
Mailing Address - State:OK
Mailing Address - Zip Code:73153-1940
Mailing Address - Country:US
Mailing Address - Phone:405-503-3296
Mailing Address - Fax:
Practice Address - Street 1:3200 NW 48TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-5900
Practice Address - Country:US
Practice Address - Phone:405-503-3296
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-19
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKBHRS101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKBHRSOtherODMHSAS