Provider Demographics
NPI:1811016082
Name:MAZUR, DONNA J (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:J
Last Name:MAZUR
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 1:108 MORGAN DR
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-6834
Mailing Address - Country:US
Mailing Address - Phone:720-448-4822
Mailing Address - Fax:
Practice Address - Street 1:108 MORGAN DR
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-6834
Practice Address - Country:US
Practice Address - Phone:720-448-4822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP13115235Z00000X
PASL016382235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist