Provider Demographics
NPI:1922533678
Name:CODEGHINI, DONNA X (SLP)
Entity Type:Individual
Prefix:MISS
First Name:DONNA
Middle Name:
Last Name:CODEGHINI
Suffix:X
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 PAULINE ST
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06615-7833
Mailing Address - Country:US
Mailing Address - Phone:203-218-4301
Mailing Address - Fax:
Practice Address - Street 1:95 PAULINE ST
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:CT
Practice Address - Zip Code:06615-7833
Practice Address - Country:US
Practice Address - Phone:203-218-4301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-01
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000922235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist