Provider Demographics
NPI:1295121192
Name:RHONDA FREEMAN-MAZE
Entity type:Organization
Organization Name:RHONDA FREEMAN-MAZE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:FREEMAN-MAZE
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:505-804-7297
Mailing Address - Street 1:PO BOX 278
Mailing Address - Street 2:
Mailing Address - City:CEDAR CREST
Mailing Address - State:NM
Mailing Address - Zip Code:87008-0278
Mailing Address - Country:US
Mailing Address - Phone:505-804-7297
Mailing Address - Fax:505-281-3002
Practice Address - Street 1:12216 HWY 14 N
Practice Address - Street 2:
Practice Address - City:CEDAR CREST
Practice Address - State:NM
Practice Address - Zip Code:87008-9001
Practice Address - Country:US
Practice Address - Phone:505-804-7297
Practice Address - Fax:505-281-3002
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRUE NORTH FAMILY COUNSELING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-04-08
Last Update Date:2015-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0154231101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty