Provider Demographics
NPI:1558557504
Name:MULLEN, DONNA MAE (MS, CCC-A)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:MAE
Last Name:MULLEN
Suffix:
Gender:F
Credentials:MS, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2315 N LAKE DR
Mailing Address - Street 2:SUITE 1005
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53211-4518
Mailing Address - Country:US
Mailing Address - Phone:414-271-4141
Mailing Address - Fax:
Practice Address - Street 1:2315 N LAKE DR
Practice Address - Street 2:SUITE 1005
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53211-4518
Practice Address - Country:US
Practice Address - Phone:414-271-4141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-23
Last Update Date:2007-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI108237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter