Provider Demographics
NPI:1164710869
Name:ADAMS, DONALD L (SLP)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:L
Last Name:ADAMS
Suffix:
Gender:M
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 S WESTON ST
Mailing Address - Street 2:
Mailing Address - City:RENSSELAER
Mailing Address - State:IN
Mailing Address - Zip Code:47978-3151
Mailing Address - Country:US
Mailing Address - Phone:219-819-4478
Mailing Address - Fax:
Practice Address - Street 1:327 S WESTON ST
Practice Address - Street 2:
Practice Address - City:RENSSELAER
Practice Address - State:IN
Practice Address - Zip Code:47978-3151
Practice Address - Country:US
Practice Address - Phone:219-819-4478
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-14
Last Update Date:2011-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22003630A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist