Provider Demographics
NPI:1992003222
Name:GARDNER, RHONNIE (SLPA)
Entity Type:Individual
Prefix:MRS
First Name:RHONNIE
Middle Name:
Last Name:GARDNER
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 GREAT WORKS RD
Mailing Address - Street 2:
Mailing Address - City:EDMUNDS TWP
Mailing Address - State:ME
Mailing Address - Zip Code:04628-5200
Mailing Address - Country:US
Mailing Address - Phone:207-726-5183
Mailing Address - Fax:
Practice Address - Street 1:16 GREAT WORKS RD
Practice Address - Street 2:
Practice Address - City:EDMUNDS TWP
Practice Address - State:ME
Practice Address - Zip Code:04628-5200
Practice Address - Country:US
Practice Address - Phone:207-726-5183
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-10
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME3898742355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant