Provider Information for 1124003322
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RHONDA S BLACKWELL-ALTHAGE LPC
Other Names:Former Name:RHONDA S BLACKWELLSex: Female
NPI: 1124003322
Last Updated: 2024-06-03
Certification Date: 2024-06-03
Certification Date: 2024-06-03
Details
Name | Value | ||||||||
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NPI | 1124003322 | ||||||||
Enumeration Date | 2005-12-09 | ||||||||
NPI Type | NPI-1 Individual | ||||||||
Sole Proprietor | YES | ||||||||
Status | Active | ||||||||
Mailing Address | 1060 E SPRINGFIELD RD SULLIVAN, MO 63080-1361 United States Phone: 314-541-9930 | Fax: | ||||||||
Primary Practice Address | 13160 COUNTY RD 3610 ST. JAMES, MO 65559 United States Phone: 573-265-3251 | Fax:573-265-2508 | ||||||||
Secondary Practice Address(es) | 3001 WARRIOR LN | ||||||||
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