Provider Demographics
NPI:1427779115
Name:M KIRCHOFF, RHONDA
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:
Last Name:M KIRCHOFF
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 1:900 BUTTERCUP LN
Mailing Address - Street 2:
Mailing Address - City:WIMBERLEY
Mailing Address - State:TX
Mailing Address - Zip Code:78676-5440
Mailing Address - Country:US
Mailing Address - Phone:512-585-6989
Mailing Address - Fax:
Practice Address - Street 1:900 BUTTERCUP LN
Practice Address - Street 2:
Practice Address - City:WIMBERLEY
Practice Address - State:TX
Practice Address - Zip Code:78676-5440
Practice Address - Country:US
Practice Address - Phone:512-585-6989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-09
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14749235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist