Provider Demographics
NPI:1093879934
Name:TYLER, RHONDA LEE (MA,CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:LEE
Last Name:TYLER
Suffix:
Gender:F
Credentials:MA,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5101 ANKENY ST
Mailing Address - Street 2:
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97603-8504
Mailing Address - Country:US
Mailing Address - Phone:541-591-1399
Mailing Address - Fax:
Practice Address - Street 1:5101 ANKENY ST
Practice Address - Street 2:
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97603-8504
Practice Address - Country:US
Practice Address - Phone:541-591-1399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR12014235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist