Provider Demographics
NPI:1386667970
Name:HEINRICH, DONNA
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:HEINRICH
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 1:3240 WASHINGTON RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MCMURRAY
Mailing Address - State:PA
Mailing Address - Zip Code:15317-3180
Mailing Address - Country:US
Mailing Address - Phone:724-941-4434
Mailing Address - Fax:
Practice Address - Street 1:3240 WASHINGTON RD
Practice Address - Street 2:SUITE 200
Practice Address - City:MCMURRAY
Practice Address - State:PA
Practice Address - Zip Code:15317-3180
Practice Address - Country:US
Practice Address - Phone:724-941-4434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL005278235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017608160005Medicaid