Provider Demographics
NPI:1730867094
Name:BOUVIER, RHONDA LEE
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:LEE
Last Name:BOUVIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3632 ROUTE E
Mailing Address - Street 2:
Mailing Address - City:ROCKY COMFORT
Mailing Address - State:MO
Mailing Address - Zip Code:64861-7234
Mailing Address - Country:US
Mailing Address - Phone:417-455-6967
Mailing Address - Fax:
Practice Address - Street 1:180 E SUNBRIDGE DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-2830
Practice Address - Country:US
Practice Address - Phone:479-444-4027
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-07
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021046820237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist