Provider Demographics
NPI:1891266755
Name:KLINGER, DONNA (MS, CCC,SLP)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:KLINGER
Suffix:
Gender:F
Credentials:MS, CCC,SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5770 MILE LANE RD
Mailing Address - Street 2:
Mailing Address - City:SAYRE
Mailing Address - State:PA
Mailing Address - Zip Code:18840-9454
Mailing Address - Country:US
Mailing Address - Phone:570-637-1919
Mailing Address - Fax:
Practice Address - Street 1:5770 MILE LANE RD
Practice Address - Street 2:
Practice Address - City:SAYRE
Practice Address - State:PA
Practice Address - Zip Code:18840-9454
Practice Address - Country:US
Practice Address - Phone:570-637-1919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL010260235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist