Provider Demographics
NPI:1851046262
Name:RHODES, LAUREN ELISABETH (MS)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:ELISABETH
Last Name:RHODES
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:FECTEAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1251 THOREAU DR APT 303
Mailing Address - Street 2:
Mailing Address - City:CELEBRATION
Mailing Address - State:FL
Mailing Address - Zip Code:34747-5514
Mailing Address - Country:US
Mailing Address - Phone:802-922-7638
Mailing Address - Fax:
Practice Address - Street 1:7758 WALLACE RD STE 1
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-7217
Practice Address - Country:US
Practice Address - Phone:802-922-7638
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-14
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3356106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist