Provider Demographics
NPI:1740229079
Name:RHOADES, MARY MARGARET (PHD)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:MARGARET
Last Name:RHOADES
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 1:518 DUNNING ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53704-5633
Mailing Address - Country:US
Mailing Address - Phone:608-241-0896
Mailing Address - Fax:
Practice Address - Street 1:4785 HAYES RD STE 100
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53704-7364
Practice Address - Country:US
Practice Address - Phone:608-242-7160
Practice Address - Fax:608-242-7153
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WIR320000003710103TS0200X
WI1917-057103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool