Provider Demographics
NPI:1841361680
Name:LAVIN, RHONDA A (MSCCC-SLP)
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:A
Last Name:LAVIN
Suffix:
Gender:F
Credentials:MSCCC-SLP
Other - Prefix:
Other - First Name:RHONDA
Other - Middle Name:A
Other - Last Name:MAX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2200 SOUTHLEA DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45459-3641
Mailing Address - Country:US
Mailing Address - Phone:937-266-7054
Mailing Address - Fax:
Practice Address - Street 1:9464 US HIGHWAY 36
Practice Address - Street 2:
Practice Address - City:SAINT PARIS
Practice Address - State:OH
Practice Address - Zip Code:43072-9367
Practice Address - Country:US
Practice Address - Phone:937-663-4449
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP 5560235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist