Provider Demographics
NPI:1700037702
Name:DONNELL, MICHELLE MARIE (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:MARIE
Last Name:DONNELL
Suffix:
Gender:F
Credentials:MS CCC-SLP
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Mailing Address - Street 1:3804 KELLEY AVENUE
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72762
Mailing Address - Country:US
Mailing Address - Phone:479-750-8880
Mailing Address - Fax:479-927-9711
Practice Address - Street 1:3804 KELLEY AVENUE
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762
Practice Address - Country:US
Practice Address - Phone:479-750-8770
Practice Address - Fax:479-306-2002
Is Sole Proprietor?:No
Enumeration Date:2008-10-08
Last Update Date:2018-07-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ARSP#1807235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist