Provider Demographics
NPI:1174995229
Name:QUARTERMAN, RHONDA (LAC)
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:
Last Name:QUARTERMAN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4250 E CAMELBACK RD
Mailing Address - Street 2:SUITE K-300
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-8301
Mailing Address - Country:US
Mailing Address - Phone:602-343-8232
Mailing Address - Fax:602-343-8233
Practice Address - Street 1:4250 E CAMELBACK RD
Practice Address - Street 2:SUITE K-300
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-8301
Practice Address - Country:US
Practice Address - Phone:602-343-8232
Practice Address - Fax:602-343-8233
Is Sole Proprietor?:No
Enumeration Date:2015-10-28
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-15795101Y00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor