Provider Demographics
NPI:1588991087
Name:GRIGERY, RHONDA JO II
Entity type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:JO
Last Name:GRIGERY
Suffix:II
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:HC 68 BOX 24
Mailing Address - Street 2:
Mailing Address - City:DES ARC
Mailing Address - State:MO
Mailing Address - Zip Code:63636-9704
Mailing Address - Country:US
Mailing Address - Phone:573-598-3419
Mailing Address - Fax:
Practice Address - Street 1:HC 68 BOX 24D
Practice Address - Street 2:
Practice Address - City:DES ARC
Practice Address - State:MO
Practice Address - Zip Code:63636-9704
Practice Address - Country:US
Practice Address - Phone:573-598-3419
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-04
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator