Donette Faye Marks, SLPA

Individual provider Active NPI Speech-Language Assistant · Burbank, WA

NPI 1972857100 · NPPES record last updated Nov 9, 2012

Key facts

NPI
1972857100
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Assistant 2355S0801X
License
SP60241672 (WA)
Practice address
755 Maple St
Burbank, WA 99323-8523
Phone
(509) 547-2136
Fax
(509) 546-0603
NPI assigned
Nov 9, 2012
Sex
Female
Sole proprietor
No

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
SP60241672WAMDSpeech-Language Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X SP60241672 WA Yes

Addresses

Primary practice location

755 Maple St
Burbank, WA 99323-8523

Mailing address

755 Maple St
Burbank, WA 99323-8523
Phone (509) 547-2136

Other names

  • Mrs. Donette Faye Miller Former name

Other providers in Burbank, WA

All providers in Burbank, WA · Speech-Language Assistant in Washington

Sources for this page

Verify at the official NPI Registry.