Provider Demographics
NPI:1114168200
Name:PAINTER, D LEE (MA CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:D
Middle Name:LEE
Last Name:PAINTER
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:LEE
Other - Middle Name:MARIANO
Other - Last Name:PAINTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1517 WOODLAND RD UNIT A
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-4246
Mailing Address - Country:US
Mailing Address - Phone:610-329-8671
Mailing Address - Fax:
Practice Address - Street 1:1517 WOODLAND RD UNIT A
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-4246
Practice Address - Country:US
Practice Address - Phone:610-329-8671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-18
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEO1-0001572235Z00000X
PASL001509L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist