Provider Demographics
NPI:1366176828
Name:PERKINS, RONDELLE DONELLE I
Entity type:Individual
Prefix:MR
First Name:RONDELLE
Middle Name:DONELLE
Last Name:PERKINS
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16031 PIONEER BLVD APT F10
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-7132
Mailing Address - Country:US
Mailing Address - Phone:347-552-1262
Mailing Address - Fax:
Practice Address - Street 1:16031 PIONEER BLVD APT F10
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-7132
Practice Address - Country:US
Practice Address - Phone:347-552-1262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-12
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst