Individual
HEATHER A. RHODES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
1200 S POKEGAMA AVE STE 160, GRAND RAPIDS, MN 55744-4296
(218) 327-0887
Mailing address
PO BOX 607, COLERAINE, MN 55722-0607
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LP3017
MN
103T00000X
Psychologist
Primary
LP3017
MN
103TC0700X
Clinical Psychologist
LP3017
MN
103TC1900X
Counseling Psychologist
LP3017
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
402817100
—
MN
01
—
62-05533
UBH PROVIDER ID
MN
01
—
83A52RH
BCBS PROVIDER ID
MN
01
—
LP3017
BOARD OF PSYCH. LICENSE #
MN
Enumeration date
07/13/2006
Last updated
10/21/2024
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