Provider Demographics
NPI:1538723572
Name:PRZYBYLINSKI, DONNA JEANNE (MA)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:JEANNE
Last Name:PRZYBYLINSKI
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:385 PICKETT CT
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:WI
Mailing Address - Zip Code:53105-3904
Mailing Address - Country:US
Mailing Address - Phone:262-308-1146
Mailing Address - Fax:
Practice Address - Street 1:385 PICKETT CT
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:WI
Practice Address - Zip Code:53105-3904
Practice Address - Country:US
Practice Address - Phone:262-308-1146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-25
Last Update Date:2019-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1790731560Medicaid