Provider Demographics
NPI:1689646242
Name:DONCHESS, REBECCA A (MA)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:A
Last Name:DONCHESS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1032 BOARDMAN-CANFIELD RD
Mailing Address - Street 2:# 102
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44512
Mailing Address - Country:US
Mailing Address - Phone:330-726-3339
Mailing Address - Fax:330-726-0482
Practice Address - Street 1:1950 NILES CORTLAND RD NE
Practice Address - Street 2:SUITE 6
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-1077
Practice Address - Country:US
Practice Address - Phone:330-394-3300
Practice Address - Fax:330-609-6190
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA 01184231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000226441OtherANTHEM
OH04600OtherNATION EAR CARE PLAN
OH0416651Medicaid
OH000000503369OtherANTHEM
OH000000503369OtherANTHEM