Provider Demographics
NPI:1083025514
Name:DONOVAN, DANA (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:DANA
Middle Name:
Last Name:DONOVAN
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:
Other - Last Name:COURT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:110 W 6TH ST
Mailing Address - Street 2:SUITE 140
Mailing Address - City:OSWEGO
Mailing Address - State:NY
Mailing Address - Zip Code:13126
Mailing Address - Country:US
Mailing Address - Phone:315-349-5558
Mailing Address - Fax:315-349-5652
Practice Address - Street 1:110 W 6TH ST
Practice Address - Street 2:SUITE 140
Practice Address - City:OSWEGO
Practice Address - State:NY
Practice Address - Zip Code:13126
Practice Address - Country:US
Practice Address - Phone:315-349-5558
Practice Address - Fax:315-349-5652
Is Sole Proprietor?:No
Enumeration Date:2014-05-19
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist