Provider Demographics
NPI:1831304617
Name:KNEIPP-LINGLE, DONNA K (MA, CCC, SLP)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:K
Last Name:KNEIPP-LINGLE
Suffix:
Gender:F
Credentials:MA, CCC, SLP
Other - Prefix:
Other - First Name:D.
Other - Middle Name:KATY
Other - Last Name:LINGLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, CCC, SLP
Mailing Address - Street 1:5507 WOODLINE DR
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:AR
Mailing Address - Zip Code:71854-9235
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:460 NW FRONT ST
Practice Address - Street 2:
Practice Address - City:ASHDOWN
Practice Address - State:AR
Practice Address - Zip Code:71822-2700
Practice Address - Country:US
Practice Address - Phone:870-898-4404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR201783235Z00000X
TX19436235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR13927721Medicaid