Provider Demographics
NPI:1285205690
Name:SUNG, RONA (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:RONA
Middle Name:
Last Name:SUNG
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 1:245 TERRACINA BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-4852
Mailing Address - Country:US
Mailing Address - Phone:909-478-7975
Mailing Address - Fax:909-307-0933
Practice Address - Street 1:245 TERRACINA BLVD STE 101
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-4852
Practice Address - Country:US
Practice Address - Phone:909-478-7975
Practice Address - Fax:909-307-0933
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-07
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist