Provider Demographics
NPI:1134779572
Name:RHOADS, DANIEL JOHN (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:JOHN
Last Name:RHOADS
Suffix:
Gender:M
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 12381
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97309-0381
Mailing Address - Country:US
Mailing Address - Phone:971-599-1712
Mailing Address - Fax:888-835-4257
Practice Address - Street 1:220 NE NORTON LN
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128-8470
Practice Address - Country:US
Practice Address - Phone:971-599-1712
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-18
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR015591235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty