Provider Demographics
NPI:1154578664
Name:DRAWDY, RHONDA KAY
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:KAY
Last Name:DRAWDY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7664 GERMANY CANAL RD
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34987-3300
Mailing Address - Country:US
Mailing Address - Phone:772-461-9954
Mailing Address - Fax:771-461-9954
Practice Address - Street 1:7664 GERMANY CANAL RD
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34987-3300
Practice Address - Country:US
Practice Address - Phone:772-461-9954
Practice Address - Fax:771-461-9954
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-26
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZSA7608235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL889862600Medicaid