Basic Information
| Provider Information | |||||||||
| NPI: | 1295274421 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FERRELL | ||||||||
| FirstName: | RHONDA | ||||||||
| MiddleName: | CHERI | ||||||||
| NamePrefix: | MISS | ||||||||
| NameSuffix: | |||||||||
| Credential: | B.A. COMMUNICATIONS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 115 PRIVATE ROAD 977 | ||||||||
| Address2: | |||||||||
| City: | PEDRO | ||||||||
| State: | OH | ||||||||
| PostalCode: | 456598608 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7405341386 | ||||||||
| FaxNumber: | 7405341516 | ||||||||
| Practice Location | |||||||||
| Address1: | 115 PRIVATE ROAD 977 | ||||||||
| Address2: | |||||||||
| City: | PEDRO | ||||||||
| State: | OH | ||||||||
| PostalCode: | 45659 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7405341386 | ||||||||
| FaxNumber: | 7405341516 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/21/2017 | ||||||||
| LastUpdateDate: | 07/12/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/12/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | C.2002283-TRNE | OH | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 171M00000X | Y | Other Service Providers | Case Manager/Care Coordinator |
No ID Information.