Provider Demographics
NPI:1598224032
Name:CAMPBELL-MINNICH, RHONDA KAYE
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:KAYE
Last Name:CAMPBELL-MINNICH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10261 TOURNON DR
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-8206
Mailing Address - Country:US
Mailing Address - Phone:317-523-7333
Mailing Address - Fax:
Practice Address - Street 1:600 E CARMEL DR STE 119
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-3049
Practice Address - Country:US
Practice Address - Phone:317-523-7333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-14
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34007695A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical