Provider Demographics
NPI:1912741372
Name:GANDY, RONDA T
Entity type:Individual
Prefix:MRS
First Name:RONDA
Middle Name:T
Last Name:GANDY
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:PO BOX 846
Mailing Address - Street 2:
Mailing Address - City:DARLINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29540-0846
Mailing Address - Country:US
Mailing Address - Phone:843-861-0006
Mailing Address - Fax:843-407-5997
Practice Address - Street 1:2143 HOFFMEYER RD STE B
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-4078
Practice Address - Country:US
Practice Address - Phone:843-307-6419
Practice Address - Fax:843-407-5997
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-20
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional