Provider Demographics
NPI:1508904749
Name:WURM, RHONDA J (LPC)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:J
Last Name:WURM
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 PLACKEMEIER DR
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63366-2944
Mailing Address - Country:US
Mailing Address - Phone:636-978-4436
Mailing Address - Fax:
Practice Address - Street 1:300 FORT ZUMWALT SQ
Practice Address - Street 2:SUITE 106
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63366-3078
Practice Address - Country:US
Practice Address - Phone:636-299-7762
Practice Address - Fax:636-272-5738
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO002562101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health