Doctor Name: | MR. CHARLES R. RHODES |
NPI Number: | 1104981802 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | L.M.H.C. |
License Number: | MH6411 |
Business Practice Address: | 24160 State Road 54 Unit 5 Lutz, FL - 335596755 |
Business Phone Number: | 8137849793 |
Business Fax Number: | 8139480788 |
Mailing Address: | 2710 Spring Meadow Dr, PLANT CITY |
State: | FL |
Postal Code: | 335669618 |
Phone Number: | 8137849793 |
Fax Number: | 8139480788 |
NPI Enumeration Date: | 12/25/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | MH6411 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |