Provider Demographics
NPI:1104805100
Name:LOVELL, RHONDA SUE (PHD)
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:SUE
Last Name:LOVELL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:RHONDA
Other - Middle Name:SUE
Other - Last Name:BAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:950 OFFICE PARK RD
Mailing Address - Street 2:SUITE 139
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50265-2549
Mailing Address - Country:US
Mailing Address - Phone:515-277-6897
Mailing Address - Fax:515-223-8293
Practice Address - Street 1:950 OFFICE PARK RD
Practice Address - Street 2:SUITE 139
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50265-2549
Practice Address - Country:US
Practice Address - Phone:515-277-6897
Practice Address - Fax:515-223-8293
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00819103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist