Provider Demographics
NPI:1659677052
Name:DALTON, RHONDA KAYE (LMT)
Entity Type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:KAYE
Last Name:DALTON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1833 HALSTEAD BLVD
Mailing Address - Street 2:#704
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32309-3460
Mailing Address - Country:US
Mailing Address - Phone:850-408-1165
Mailing Address - Fax:
Practice Address - Street 1:1833 HALSTEAD BLVD
Practice Address - Street 2:#704
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32309-3460
Practice Address - Country:US
Practice Address - Phone:850-408-1165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-01
Last Update Date:2011-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA42773225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist