Provider Demographics
NPI:1548538317
Name:BRAUN, DONNA M (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:M
Last Name:BRAUN
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:M
Other - Last Name:GOODWIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:73 6TH ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-4111
Mailing Address - Country:US
Mailing Address - Phone:516-414-8217
Mailing Address - Fax:
Practice Address - Street 1:73 6TH ST
Practice Address - Street 2:
Practice Address - City:GARDEN CITY PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-4111
Practice Address - Country:US
Practice Address - Phone:516-414-8217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-08
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009756-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist