Provider Demographics
NPI:1902160575
Name:HAFFER-MABLEY, RHONDA RAE
Entity Type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:RAE
Last Name:HAFFER-MABLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5023 SNOWBERRY ST
Mailing Address - Street 2:
Mailing Address - City:IMPERIAL
Mailing Address - State:MO
Mailing Address - Zip Code:63052-1551
Mailing Address - Country:US
Mailing Address - Phone:314-560-7215
Mailing Address - Fax:
Practice Address - Street 1:1830 JEFFCO BLVD
Practice Address - Street 2:
Practice Address - City:ARNOLD
Practice Address - State:MO
Practice Address - Zip Code:63010-2778
Practice Address - Country:US
Practice Address - Phone:314-560-7215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-28
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012018360104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker