Provider Demographics
NPI:1790195543
Name:AUBREY, RHONDA GAIL
Entity Type:Individual
Prefix:MS
First Name:RHONDA
Middle Name:GAIL
Last Name:AUBREY
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 1:84 S SEAWAY DR
Mailing Address - Street 2:
Mailing Address - City:NORTON SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:49444-3841
Mailing Address - Country:US
Mailing Address - Phone:231-733-9800
Mailing Address - Fax:231-733-1949
Practice Address - Street 1:84 S SEAWAY DR
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49444-3841
Practice Address - Country:US
Practice Address - Phone:231-733-9800
Practice Address - Fax:231-733-1949
Is Sole Proprietor?:No
Enumeration Date:2014-05-02
Last Update Date:2014-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
MI6802083511104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker