Provider Demographics
NPI:1962500389
Name:RHODES-MARSH, NADINE D, (LPAE)
Entity Type:Individual
Prefix:MRS
First Name:NADINE
Middle Name:D,
Last Name:RHODES-MARSH
Suffix:
Gender:F
Credentials:LPAE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 877
Mailing Address - Street 2:
Mailing Address - City:NEW LLANO
Mailing Address - State:LA
Mailing Address - Zip Code:71461-0887
Mailing Address - Country:US
Mailing Address - Phone:337-531-3772
Mailing Address - Fax:337-531-3760
Practice Address - Street 1:1585 3RD ST
Practice Address - Street 2:
Practice Address - City:FORT POLK
Practice Address - State:LA
Practice Address - Zip Code:71459-5102
Practice Address - Country:US
Practice Address - Phone:337-531-3922
Practice Address - Fax:337-531-3760
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK555101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health