Provider Demographics
NPI:1174762637
Name:GREENO, RHONDA KIRSTEN (BSW)
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:KIRSTEN
Last Name:GREENO
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:RHONDA
Other - Middle Name:KIRSTEN
Other - Last Name:WILHELM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSW
Mailing Address - Street 1:20687 JAMESON RD
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:WI
Mailing Address - Zip Code:54656-3675
Mailing Address - Country:US
Mailing Address - Phone:608-269-7773
Mailing Address - Fax:
Practice Address - Street 1:1407 SAINT ANDREW ST STE 100
Practice Address - Street 2:
Practice Address - City:LA CROSSE
Practice Address - State:WI
Practice Address - Zip Code:54603-2378
Practice Address - Country:US
Practice Address - Phone:608-372-3156
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-06
Last Update Date:2009-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI378-120171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator