Provider Demographics
NPI:1306093190
Name:PRYOR, RHONDA Y (SLP)
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:Y
Last Name:PRYOR
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 391
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42102-0391
Mailing Address - Country:US
Mailing Address - Phone:270-781-0028
Mailing Address - Fax:270-781-0007
Practice Address - Street 1:1600 SCOTTSVILLE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42104-3217
Practice Address - Country:US
Practice Address - Phone:270-781-0028
Practice Address - Fax:270-781-0007
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-22
Last Update Date:2008-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-1388235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist