Provider Demographics
NPI:1679238935
Name:RHODES, KATHLEEN JANE
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:JANE
Last Name:RHODES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9912 EAGLE RIVER ST
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80125-8941
Mailing Address - Country:US
Mailing Address - Phone:303-257-9388
Mailing Address - Fax:
Practice Address - Street 1:9912 EAGLE RIVER ST
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80125-8941
Practice Address - Country:US
Practice Address - Phone:303-257-9388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-02
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0015751103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist