Provider Demographics
NPI:1891828323
Name:WEBER, DONNA MARIE (MED CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:MARIE
Last Name:WEBER
Suffix:
Gender:F
Credentials:MED CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 BRIARCLIFF LN
Mailing Address - Street 2:
Mailing Address - City:HOLLISTON
Mailing Address - State:MA
Mailing Address - Zip Code:01746-1040
Mailing Address - Country:US
Mailing Address - Phone:781-235-8720
Mailing Address - Fax:781-207-8133
Practice Address - Street 1:25 WALNUT ST
Practice Address - Street 2:SUITE 203
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02481-2152
Practice Address - Country:US
Practice Address - Phone:781-235-8720
Practice Address - Fax:781-207-8133
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1506235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist