Provider Demographics
NPI:1114185741
Name:BARTRUG, DONNA C
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:C
Last Name:BARTRUG
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 1:20346 ENNIS RD
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19947-4108
Mailing Address - Country:US
Mailing Address - Phone:302-856-1926
Mailing Address - Fax:302-856-1950
Practice Address - Street 1:200 N 8TH ST
Practice Address - Street 2:
Practice Address - City:DELMAR
Practice Address - State:DE
Practice Address - Zip Code:19940-1374
Practice Address - Country:US
Practice Address - Phone:302-846-9544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-30
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE01-0000943235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist