Provider Demographics
NPI:1659197069
Name:RHODES, JENNIFER RACHEL
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:RACHEL
Last Name:RHODES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1136 MANOR AVE NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44708-3526
Mailing Address - Country:US
Mailing Address - Phone:740-409-3638
Mailing Address - Fax:740-278-8267
Practice Address - Street 1:1136 MANOR AVE NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708-3526
Practice Address - Country:US
Practice Address - Phone:740-409-3638
Practice Address - Fax:740-278-8267
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-02
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator