Provider Demographics
NPI:1033691555
Name:MAXWELL, DONNA (SLP, OM)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:MAXWELL
Suffix:
Gender:F
Credentials:SLP, OM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25400 W 95TH LN UNIT 1801
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66227-7362
Mailing Address - Country:US
Mailing Address - Phone:913-267-4785
Mailing Address - Fax:
Practice Address - Street 1:25400 W 95TH LN UNIT 1801
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66227-7362
Practice Address - Country:US
Practice Address - Phone:913-267-4785
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-30
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist