Provider Demographics
NPI:1710995824
Name:BRANDEL, DONNA T (SLP)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:T
Last Name:BRANDEL
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:MISS
Other - First Name:DONNA
Other - Middle Name:T
Other - Last Name:HENRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:3211 HANCOCK DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-5427
Mailing Address - Country:US
Mailing Address - Phone:512-533-9313
Mailing Address - Fax:512-533-9317
Practice Address - Street 1:3211 HANCOCK DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-5427
Practice Address - Country:US
Practice Address - Phone:512-533-9313
Practice Address - Fax:512-533-9317
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15464235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8T2207OtherBCBS PROVIDER #