Provider Demographics
NPI:1396886123
Name:LOVELACE, RONDA JOLOYCE (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:RONDA
Middle Name:JOLOYCE
Last Name:LOVELACE
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:MISS
Other - First Name:RONDA
Other - Middle Name:JOLOYCE
Other - Last Name:WAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:2530 BROADWAY AVE N
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55906-4594
Mailing Address - Country:US
Mailing Address - Phone:507-259-7570
Mailing Address - Fax:888-624-3107
Practice Address - Street 1:2746 SUPERIOR DR NW
Practice Address - Street 2:SUITE 300
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-8343
Practice Address - Country:US
Practice Address - Phone:507-288-0064
Practice Address - Fax:507-288-3993
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2018-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7182235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist