Provider Demographics
NPI:1104905926
Name:NETBURN, RHODA A
Entity type:Individual
Prefix:MS
First Name:RHODA
Middle Name:A
Last Name:NETBURN
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 1:39 BACON ST
Mailing Address - Street 2:#3
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02451
Mailing Address - Country:US
Mailing Address - Phone:781-373-5777
Mailing Address - Fax:
Practice Address - Street 1:789 CLAPBOARDTREE ST
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:MA
Practice Address - Zip Code:02090-1717
Practice Address - Country:US
Practice Address - Phone:781-762-4001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health