Provider Demographics
NPI:1881340065
Name:DONOHUE, MONICA RENE' (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:RENE'
Last Name:DONOHUE
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 1:4400 FOSTER LN
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76549-2782
Mailing Address - Country:US
Mailing Address - Phone:254-336-6951
Mailing Address - Fax:
Practice Address - Street 1:4400 FOSTER LN
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76549-2782
Practice Address - Country:US
Practice Address - Phone:254-336-6951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-25
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX235Z00000X
TX111791235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist