Provider Demographics
NPI:1073149357
Name:ALLEE, RONDA LYNN (OTR)
Entity Type:Individual
Prefix:
First Name:RONDA
Middle Name:LYNN
Last Name:ALLEE
Suffix:
Gender:F
Credentials:OTR
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 462
Mailing Address - Street 2:
Mailing Address - City:KIRBYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75956-0462
Mailing Address - Country:US
Mailing Address - Phone:409-381-1677
Mailing Address - Fax:
Practice Address - Street 1:3543 FM 1013 W
Practice Address - Street 2:
Practice Address - City:KIRBYVILLE
Practice Address - State:TX
Practice Address - Zip Code:75956-3044
Practice Address - Country:US
Practice Address - Phone:409-381-1677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-18
Last Update Date:2020-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX117118225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX117118OtherTEXAS BOARD OF OCCUPATIONAL THERAPY EXAMINERS