Provider Demographics
NPI:1063039840
Name:ETTER, RHONDA RENEE
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:RENEE
Last Name:ETTER
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 1:410 N 29TH ST
Mailing Address - Street 2:
Mailing Address - City:PARSONS
Mailing Address - State:KS
Mailing Address - Zip Code:67357-2417
Mailing Address - Country:US
Mailing Address - Phone:620-423-7771
Mailing Address - Fax:
Practice Address - Street 1:2601 GABRIEL AVE
Practice Address - Street 2:
Practice Address - City:PARSONS
Practice Address - State:KS
Practice Address - Zip Code:67357-2341
Practice Address - Country:US
Practice Address - Phone:620-421-6550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-29
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1106235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist