Provider Demographics
NPI:1447956917
Name:MAIDEN, RODNEY J
Entity type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:J
Last Name:MAIDEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6000 MERIDIAN LN
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-2706
Mailing Address - Country:US
Mailing Address - Phone:225-229-1628
Mailing Address - Fax:
Practice Address - Street 1:6707 TAYLOR CIR STE B
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-7706
Practice Address - Country:US
Practice Address - Phone:334-676-2368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALALC03998101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health