Provider Demographics
NPI:1184719643
Name:DONAWAY, EVELYN FAY (MSCCC/SLP)
Entity type:Individual
Prefix:
First Name:EVELYN
Middle Name:FAY
Last Name:DONAWAY
Suffix:
Gender:F
Credentials:MSCCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3426 KINSER DRIVE
Mailing Address - Street 2:
Mailing Address - City:HARTVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:65667
Mailing Address - Country:US
Mailing Address - Phone:417-741-1013
Mailing Address - Fax:
Practice Address - Street 1:1200 NORTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:MOUNTAIN GROVE
Practice Address - State:MO
Practice Address - Zip Code:65711
Practice Address - Country:US
Practice Address - Phone:417-926-5699
Practice Address - Fax:417-926-5703
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006020966235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist