Provider Demographics
NPI:1639344476
Name:RHODES, LUEBIRDA
Entity type:Individual
Prefix:
First Name:LUEBIRDA
Middle Name:
Last Name:RHODES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LUEBIRDA
Other - Middle Name:
Other - Last Name:RHODES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NA
Mailing Address - Street 1:8932 NATURAL BRIDGE RD
Mailing Address - Street 2:NATURAL BRIDGET BLV
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63121-3917
Mailing Address - Country:US
Mailing Address - Phone:314-446-6991
Mailing Address - Fax:
Practice Address - Street 1:8932 NATURAL BRIDGE RD
Practice Address - Street 2:NATURAL BRIDGET BLV
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63121-3917
Practice Address - Country:US
Practice Address - Phone:314-446-6991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-23
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging