Donna M Black, SLP

Individual provider Active NPI Speech-Language Pathologist · Dillon, MT

NPI 1730346552 · NPPES record last updated Apr 20, 2020

Key facts

NPI
1730346552
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
263543 (KY)
Practice address
200 N Oregon St
Dillon, MT 59725-3624
Phone
(406) 683-5105
Fax
(406) 683-6388
NPI assigned
May 20, 2008
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
263543KYMDSpeech-Language Pathologist
1172MTMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 1172 MT
Speech-Language Pathologist 235Z00000X 263543 KY Yes

Addresses

Primary practice location

200 N Oregon St
Dillon, MT 59725-3624

Mailing address

200 N Oregon St
Dillon, MT 59725-3624
Phone (406) 683-5105

Other providers in Dillon, MT

All providers in Dillon, MT · Speech-Language Pathologist in Montana

Sources for this page

Verify at the official NPI Registry.