Provider Demographics
NPI:1215581004
Name:PRINCE, DONNA DUNCAN
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:DUNCAN
Last Name:PRINCE
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 1:647 DUDLEY SHOALS RD
Mailing Address - Street 2:
Mailing Address - City:GRANITE FALLS
Mailing Address - State:NC
Mailing Address - Zip Code:28630-8444
Mailing Address - Country:US
Mailing Address - Phone:828-781-1929
Mailing Address - Fax:
Practice Address - Street 1:4012 HICKORY BLVD
Practice Address - Street 2:
Practice Address - City:GRANITE FALLS
Practice Address - State:NC
Practice Address - Zip Code:28630-8372
Practice Address - Country:US
Practice Address - Phone:828-781-1929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-30
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5321235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist