Provider Demographics
NPI:1497705578
Name:RUCERETO, RHONDA MAELING (AUD, CCC-A)
Entity Type:Individual
Prefix:MS
First Name:RHONDA
Middle Name:MAELING
Last Name:RUCERETO
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 NW BARRY RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64155-2732
Mailing Address - Country:US
Mailing Address - Phone:816-413-2519
Mailing Address - Fax:
Practice Address - Street 1:501 NW BARRY RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64155-2732
Practice Address - Country:US
Practice Address - Phone:816-413-2519
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1972231H00000X
MO2002020510231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2002023852OtherHEARING AID LICENSE
MO2002020510OtherAUDIOLOGY LICENSE
MO335932109Medicaid
MO335932109Medicaid
MO2002020510OtherAUDIOLOGY LICENSE
KS100427480AMedicare ID - Type Unspecified