Provider Demographics
NPI:1215190715
Name:VELDHUIZEN, RODNEY DALE (D MIN)
Entity type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:DALE
Last Name:VELDHUIZEN
Suffix:
Gender:
Credentials:D MIN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11455 ELLIOTT RD
Mailing Address - Street 2:
Mailing Address - City:CUSTER
Mailing Address - State:SD
Mailing Address - Zip Code:57730-8239
Mailing Address - Country:US
Mailing Address - Phone:605-760-3633
Mailing Address - Fax:605-760-3633
Practice Address - Street 1:11455 ELLIOTT RD
Practice Address - Street 2:
Practice Address - City:CUSTER
Practice Address - State:SD
Practice Address - Zip Code:57730-8239
Practice Address - Country:US
Practice Address - Phone:605-760-3633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-03
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDLMFT1207106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist