Provider Demographics
NPI:1023224110
Name:RAINEY, VONDA KAYE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:VONDA
Middle Name:KAYE
Last Name:RAINEY
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 STEWART RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-9526
Mailing Address - Country:US
Mailing Address - Phone:501-821-4400
Mailing Address - Fax:
Practice Address - Street 1:1400 STEWART RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72223-9526
Practice Address - Country:US
Practice Address - Phone:501-821-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1556235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist