Provider Demographics
NPI:1720171028
Name:RONCK, SHARON KAY (MS CCC)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:KAY
Last Name:RONCK
Suffix:
Gender:F
Credentials:MS CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 E ROBERTSON ROAD
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73701-6829
Mailing Address - Country:US
Mailing Address - Phone:580-233-9692
Mailing Address - Fax:
Practice Address - Street 1:1125 E ROBERTSON ROAD
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73701-6829
Practice Address - Country:US
Practice Address - Phone:580-233-9254
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK274235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist