Provider Demographics
NPI:1669699732
Name:RHODES, STEPHANIE (OTRL)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:
Last Name:RHODES
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:MISS
Other - First Name:STEPHANIE
Other - Middle Name:
Other - Last Name:BROOKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTRL
Mailing Address - Street 1:110 UNION STA
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-4201
Mailing Address - Country:US
Mailing Address - Phone:256-895-7593
Mailing Address - Fax:
Practice Address - Street 1:5275 MILLENNIUM DR NW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35806-2457
Practice Address - Country:US
Practice Address - Phone:256-489-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2129225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist