Provider Demographics
NPI:1346644564
Name:SPIRES, RONDEL (MA CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:RONDEL
Middle Name:
Last Name:SPIRES
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 1:307 W HIGH ST
Mailing Address - Street 2:
Mailing Address - City:MC ARTHUR
Mailing Address - State:OH
Mailing Address - Zip Code:45651-1093
Mailing Address - Country:US
Mailing Address - Phone:740-596-5128
Mailing Address - Fax:
Practice Address - Street 1:307 W HIGH ST
Practice Address - Street 2:
Practice Address - City:MC ARTHUR
Practice Address - State:OH
Practice Address - Zip Code:45651-1093
Practice Address - Country:US
Practice Address - Phone:740-596-5128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-17
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP7012235Z00000X
OHOH1275532235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist