Provider Demographics
NPI:1386972685
Name:RAHM, SANDRA SUE (LPC)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:SUE
Last Name:RAHM
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 1:413 E SPRING ST
Mailing Address - Street 2:
Mailing Address - City:BOONVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:65233-1573
Mailing Address - Country:US
Mailing Address - Phone:660-882-6400
Mailing Address - Fax:660-882-7137
Practice Address - Street 1:413 E SPRING ST
Practice Address - Street 2:
Practice Address - City:BOONVILLE
Practice Address - State:MO
Practice Address - Zip Code:65233-1573
Practice Address - Country:US
Practice Address - Phone:660-882-6400
Practice Address - Fax:660-882-7137
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-24
Last Update Date:2009-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO001772101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional