Provider Demographics
NPI:1760993380
Name:MAYES, RODNEY (MS)
Entity type:Individual
Prefix:
First Name:RODNEY
Middle Name:
Last Name:MAYES
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1326 E SILVER SHADOWS DR
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:UT
Mailing Address - Zip Code:84780-8389
Mailing Address - Country:US
Mailing Address - Phone:435-231-9084
Mailing Address - Fax:
Practice Address - Street 1:1326 E SILVER SHADOWS DR
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:UT
Practice Address - Zip Code:84780-8389
Practice Address - Country:US
Practice Address - Phone:435-231-9084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-23
Last Update Date:2025-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9722153-3904106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty