Provider Demographics
NPI:1831632413
Name:HANSON-BROWN, DONNA MARIE (MED,CCC-SP)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:MARIE
Last Name:HANSON-BROWN
Suffix:
Gender:F
Credentials:MED,CCC-SP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 RICHMOND TER
Mailing Address - Street 2:APT 1A
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10301-1501
Mailing Address - Country:US
Mailing Address - Phone:917-403-5210
Mailing Address - Fax:
Practice Address - Street 1:140 PALMA DR
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10304-3400
Practice Address - Country:US
Practice Address - Phone:718-447-1191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-30
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005230235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist