Provider Demographics
NPI:1669098265
Name:SLONAKER, RONDA ELIZABETH (MS)
Entity type:Individual
Prefix:
First Name:RONDA
Middle Name:ELIZABETH
Last Name:SLONAKER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 CRAZY PAPOOSE TRL
Mailing Address - Street 2:
Mailing Address - City:GOULDSBORO
Mailing Address - State:PA
Mailing Address - Zip Code:18424-8715
Mailing Address - Country:US
Mailing Address - Phone:252-626-7354
Mailing Address - Fax:
Practice Address - Street 1:4113 BIRNEY AVE
Practice Address - Street 2:
Practice Address - City:MOOSIC
Practice Address - State:PA
Practice Address - Zip Code:18507-1330
Practice Address - Country:US
Practice Address - Phone:570-489-5561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-19
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling