Provider Demographics
NPI:1659689636
Name:RHYNE, CHARLOTTE LEA (PHD)
Entity Type:Individual
Prefix:DR
First Name:CHARLOTTE
Middle Name:LEA
Last Name:RHYNE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1488 COUNTY ROAD 3807
Mailing Address - Street 2:
Mailing Address - City:BULLARD
Mailing Address - State:TX
Mailing Address - Zip Code:75757-6808
Mailing Address - Country:US
Mailing Address - Phone:713-876-3773
Mailing Address - Fax:903-894-6195
Practice Address - Street 1:1488 COUNTY ROAD 3807
Practice Address - Street 2:
Practice Address - City:BULLARD
Practice Address - State:TX
Practice Address - Zip Code:75757-6808
Practice Address - Country:US
Practice Address - Phone:713-876-3773
Practice Address - Fax:903-894-6195
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-23
Last Update Date:2010-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34473103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist