Provider Demographics
NPI:1982741351
Name:MILLET, DONNA M (SLP)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:M
Last Name:MILLET
Suffix:
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 1:304 BRIARDALE AVE
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-2851
Mailing Address - Country:US
Mailing Address - Phone:919-388-9591
Mailing Address - Fax:919-570-9712
Practice Address - Street 1:55 KENSINGTON DR
Practice Address - Street 2:
Practice Address - City:YOUNGSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27596-7624
Practice Address - Country:US
Practice Address - Phone:919-570-9712
Practice Address - Fax:919-570-9712
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6431235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7412436Medicaid