Provider Demographics
NPI:1932453933
Name:FREEMAN-MAZE, RHONDA (LMHC)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:
Last Name:FREEMAN-MAZE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 CARLISLE BLVD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-4905
Mailing Address - Country:US
Mailing Address - Phone:505-933-4639
Mailing Address - Fax:505-274-7338
Practice Address - Street 1:1805 CARLISLE BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-4905
Practice Address - Country:US
Practice Address - Phone:505-933-4639
Practice Address - Fax:505-274-7338
Is Sole Proprietor?:No
Enumeration Date:2012-10-30
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0154231101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health