Provider Demographics
NPI:1518990662
Name:AUDIA, RHONDA (MSW)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:
Last Name:AUDIA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7320 E FLETCHER AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33637-0916
Mailing Address - Country:US
Mailing Address - Phone:813-751-4778
Mailing Address - Fax:813-490-6226
Practice Address - Street 1:4726 N HABANA AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-7144
Practice Address - Country:US
Practice Address - Phone:813-872-7582
Practice Address - Fax:813-873-9591
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 108501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical