Provider Demographics
NPI:1285953455
Name:SMATLAK, RHONDA SUE (LPC)
Entity type:Individual
Prefix:MS
First Name:RHONDA
Middle Name:SUE
Last Name:SMATLAK
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4334 SECOR RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-4234
Mailing Address - Country:US
Mailing Address - Phone:419-291-8892
Mailing Address - Fax:
Practice Address - Street 1:2109 HUGHES DR
Practice Address - Street 2:JOBST TOWER, SUITE 640
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-3856
Practice Address - Country:US
Practice Address - Phone:419-291-8892
Practice Address - Fax:419-291-6436
Is Sole Proprietor?:No
Enumeration Date:2010-05-26
Last Update Date:2010-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC6232101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional