Provider Demographics
NPI:1285790402
Name:MAGRAM, RONNA (MA, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:RONNA
Middle Name:
Last Name:MAGRAM
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 1:1671 SW 106TH TER
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33324-7164
Mailing Address - Country:US
Mailing Address - Phone:954-577-0811
Mailing Address - Fax:954-577-0812
Practice Address - Street 1:1671 SW 106TH TER
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33324-7164
Practice Address - Country:US
Practice Address - Phone:954-577-0811
Practice Address - Fax:954-577-0812
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA3163235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist