Provider Demographics
NPI:1396980538
Name:POLANSKY, RONDA DIANE (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:RONDA
Middle Name:DIANE
Last Name:POLANSKY
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2921 BROWN TRL
Mailing Address - Street 2:SUITE # 110
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-4144
Mailing Address - Country:US
Mailing Address - Phone:817-514-6271
Mailing Address - Fax:817-514-6278
Practice Address - Street 1:2921 BROWN TRL
Practice Address - Street 2:SUITE 110
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-4144
Practice Address - Country:US
Practice Address - Phone:817-514-6271
Practice Address - Fax:817-514-6278
Is Sole Proprietor?:No
Enumeration Date:2008-12-02
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16290235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist