Basic Information
| Provider Information | |||||||||
| NPI: | 1851795496 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FIELDS | ||||||||
| FirstName: | RHONDA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7305 E STATE RD. 28 | ||||||||
| Address2: | |||||||||
| City: | UNION CITY | ||||||||
| State: | IN | ||||||||
| PostalCode: | 47390 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9374170382 | ||||||||
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| Practice Location | |||||||||
| Address1: | 212 S. MAIN STREET | ||||||||
| Address2: | |||||||||
| City: | GREENVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 45331 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9375481635 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/10/2014 | ||||||||
| LastUpdateDate: | 10/10/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | S.1450375 | OH | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.