Provider Demographics
NPI:1518181205
Name:WINTER, DONNA K (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:K
Last Name:WINTER
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3587 E STATE ROAD 358
Mailing Address - Street 2:
Mailing Address - City:ELNORA
Mailing Address - State:IN
Mailing Address - Zip Code:47529-5131
Mailing Address - Country:US
Mailing Address - Phone:812-692-5164
Mailing Address - Fax:812-692-5164
Practice Address - Street 1:3587 E STATE ROAD 358
Practice Address - Street 2:
Practice Address - City:ELNORA
Practice Address - State:IN
Practice Address - Zip Code:47529-5131
Practice Address - Country:US
Practice Address - Phone:812-692-5164
Practice Address - Fax:812-692-5164
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22003378A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist