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Individual

MRS. SUSANNA HUMBARD RONGEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
2000 S PROMENADE BLVD, ROGERS, AR 72758-9073
(479) 427-7722
(417) 350-1935
Mailing address
3600 S NATIONAL AVE, SPRINGFIELD, MO 65807-7311
(417) 322-6622
(417) 350-1935

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
916-C
AR
163WP0200X
Pediatric Registered Nurse
R49764
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
203132795
AR
Enumeration date
06/30/2010
Last updated
09/28/2021
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