Provider Demographics
NPI:1174022297
Name:STALB, RHONDA MARIE (LMFT)
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:MARIE
Last Name:STALB
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8496 WILKINSVILLE ROAD
Mailing Address - Street 2:SUITE 101 #118
Mailing Address - City:MILLINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38053-1556
Mailing Address - Country:US
Mailing Address - Phone:256-604-7016
Mailing Address - Fax:
Practice Address - Street 1:8496 WILKINSVILLE ROAD
Practice Address - Street 2:SUITE 101 #118
Practice Address - City:MILLINGTON
Practice Address - State:TN
Practice Address - Zip Code:38053-1556
Practice Address - Country:US
Practice Address - Phone:256-604-7016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-04
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALL478106H00000X
TN1857106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist