Ronda Wishert Grant

Individual provider Active NPI Speech-Language Pathologist · Port Lavaca, TX

NPI 1407685779 · NPPES record last updated Jul 26, 2024

Key facts

NPI
1407685779
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
Practice address
607 Tilley St.
Special Programs
Port Lavaca, TX 77979
Phone
(361) 552-9404
NPI assigned
Jul 26, 2024
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X Yes

Addresses

Primary practice location

607 Tilley St.
Special Programs
Port Lavaca, TX 77979

Mailing address

9 Sago
Port Lavaca, TX 77979-5468
Phone (361) 676-6145

Other providers in Port Lavaca, TX

All providers in Port Lavaca, TX · Speech-Language Pathologist in Texas

Sources for this page

Verify at the official NPI Registry.