Provider Demographics
NPI:1821593559
Name:HAIN, RONDA LOUISE
Entity Type:Individual
Prefix:
First Name:RONDA
Middle Name:LOUISE
Last Name:HAIN
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 1:2112 W SAINT THOMAS MORE WAY
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-8331
Mailing Address - Country:US
Mailing Address - Phone:509-218-1556
Mailing Address - Fax:
Practice Address - Street 1:2112 W SAINT THOMAS MORE WAY
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-8331
Practice Address - Country:US
Practice Address - Phone:509-218-1556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-26
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00007032101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health