Provider Demographics
NPI:1477097467
Name:DONOHOE, LAUREN (MA, CCC-SLP, TSSLD)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:DONOHOE
Suffix:
Gender:F
Credentials:MA, CCC-SLP, TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6445 218TH ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11364-2237
Mailing Address - Country:US
Mailing Address - Phone:718-423-8395
Mailing Address - Fax:718-423-8472
Practice Address - Street 1:6445 218TH ST
Practice Address - Street 2:
Practice Address - City:OAKLAND GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11364-2237
Practice Address - Country:US
Practice Address - Phone:718-423-8395
Practice Address - Fax:718-423-8472
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-08
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024456235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist