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General NPI Number Information
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NPI Number | 1942098561
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Entity Type | Individual
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Provider Name | RONDA J AVERY RDH, LMT
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Gender | Female
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Dates
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Enumeration Date | 04/25/2025
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Last Update Date | 04/25/2025
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Provider Practice Location Address
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Address Line | 303 KIMBALL POND RD
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City | NEW SHARON
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State | ME
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Zip | 04955-3703
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Country | US
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Telephone | 207-500-0454
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Fax |
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Provider Business Mailing Address
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Address Line | 270 MANCHESTER RD
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City | BELGRADE
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State | ME
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Zip | 04917-3823
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Country | US
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Telephone | 860-609-2253
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT5996
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | RDH4146
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License Number State | ME
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