1194016477 NPI number — MS. RHONDA J GREENHAW MA, BCBA

Table of content: MS. RHONDA J GREENHAW MA, BCBA (NPI 1194016477)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194016477 NPI number — MS. RHONDA J GREENHAW MA, BCBA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GREENHAW
Provider First Name:
RHONDA
Provider Middle Name:
J
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MA, BCBA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194016477
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/27/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3832 SW 33RD CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WEST PARK
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33023-5631
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
262-707-3257
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6303 BLUE LAGOON DR STE 400
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33126-6040
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
833-458-0386
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/21/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103K00000X , with the licence number:  20-140 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com