Provider Demographics
NPI:1952541443
Name:NIETFELD-SUNDERMANN, RHONDA B (MSW, LICSW)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:B
Last Name:NIETFELD-SUNDERMANN
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10
Mailing Address - Street 2:
Mailing Address - City:STARBUCK
Mailing Address - State:MN
Mailing Address - Zip Code:56381-0010
Mailing Address - Country:US
Mailing Address - Phone:320-239-2257
Mailing Address - Fax:320-239-1420
Practice Address - Street 1:500 JOHN ST
Practice Address - Street 2:
Practice Address - City:STARBUCK
Practice Address - State:MN
Practice Address - Zip Code:56381-4623
Practice Address - Country:US
Practice Address - Phone:320-239-2257
Practice Address - Fax:320-239-1420
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-24
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN138521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical