Healthcare Provider Details

I. General information

NPI: 1154578664
Provider Name (Legal Business Name): RHONDA KAY DRAWDY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2008
Last Update Date: 08/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7664 GERMANY CANAL RD
FORT PIERCE FL
34987-3300
US

IV. Provider business mailing address

7664 GERMANY CANAL RD
FORT PIERCE FL
34987-3300
US

V. Phone/Fax

Practice location:
  • Phone: 772-461-9954
  • Fax: 771-461-9954
Mailing address:
  • Phone: 772-461-9954
  • Fax: 771-461-9954

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA7608
License Number StateZZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: