Provider Demographics
NPI:1720243835
Name:DENSBORN, RHONDA JO (MA LLP)
Entity Type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:JO
Last Name:DENSBORN
Suffix:
Gender:F
Credentials:MA LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4738 BURGIS AVE SE
Mailing Address - Street 2:
Mailing Address - City:KENTWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:49508-4554
Mailing Address - Country:US
Mailing Address - Phone:616-726-6718
Mailing Address - Fax:
Practice Address - Street 1:4738 BURGIS AVE SE
Practice Address - Street 2:
Practice Address - City:KENTWOOD
Practice Address - State:MI
Practice Address - Zip Code:49508-4554
Practice Address - Country:US
Practice Address - Phone:616-726-6718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-29
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301012175103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling