Provider Demographics
NPI:1871648683
Name:IMHOFF, RHONDA ELAINE (OT)
Entity Type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:ELAINE
Last Name:IMHOFF
Suffix:
Gender:F
Credentials:OT
Other - Prefix:MISS
Other - First Name:RHONDA
Other - Middle Name:ELAINE
Other - Last Name:KUESTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:56781 LITTLE MONITEAU RD
Mailing Address - Street 2:
Mailing Address - City:CALIFORNIA
Mailing Address - State:MO
Mailing Address - Zip Code:65018-3066
Mailing Address - Country:US
Mailing Address - Phone:573-796-2331
Mailing Address - Fax:
Practice Address - Street 1:1115 FAIRGROUNDS RD
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65109-5443
Practice Address - Country:US
Practice Address - Phone:573-634-3070
Practice Address - Fax:573-636-3247
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1455225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist