Provider Demographics
NPI:1760067896
Name:LEFTWICH, RONICA (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:RONICA
Middle Name:
Last Name:LEFTWICH
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 1:8640 UNIVERSITY CITY BLVD
Mailing Address - Street 2:SUITE A3 #271
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28213-3506
Mailing Address - Country:US
Mailing Address - Phone:704-317-5454
Mailing Address - Fax:
Practice Address - Street 1:7440 PONDERS END LN
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28213-5752
Practice Address - Country:US
Practice Address - Phone:704-317-5454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-10
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist