Provider Demographics
NPI:1962130922
Name:RASCON, RHIANNA SIAN
Entity type:Individual
Prefix:
First Name:RHIANNA
Middle Name:SIAN
Last Name:RASCON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RHIANNA
Other - Middle Name:SIAN
Other - Last Name:CHEETHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:318 W 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85122-4327
Mailing Address - Country:US
Mailing Address - Phone:520-423-7679
Mailing Address - Fax:
Practice Address - Street 1:318 W 3RD AVE
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122-4327
Practice Address - Country:US
Practice Address - Phone:520-423-7679
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-09
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker