Provider Demographics
NPI:1063554905
Name:LEWIS, RHONDA (MA CCC-SLP)
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9951 LAKE ELMHURST LN
Mailing Address - Street 2:APT. 303
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-4135
Mailing Address - Country:US
Mailing Address - Phone:407-657-2104
Mailing Address - Fax:407-657-2104
Practice Address - Street 1:9951 LAKE ELMHURST LN
Practice Address - Street 2:APT. 303
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-4135
Practice Address - Country:US
Practice Address - Phone:407-657-2104
Practice Address - Fax:407-657-2104
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 8409235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist