Provider Demographics
NPI:1063714376
Name:MCDONALD, LOUISE ANTOINETTE (MA, CCC,SLP)
Entity type:Individual
Prefix:
First Name:LOUISE
Middle Name:ANTOINETTE
Last Name:MCDONALD
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 1:32500 CONCORD DR STE 343
Mailing Address - Street 2:
Mailing Address - City:MADISON HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48071-1119
Mailing Address - Country:US
Mailing Address - Phone:866-876-2747
Mailing Address - Fax:586-620-6040
Practice Address - Street 1:32500 CONCORD DR STE 343
Practice Address - Street 2:
Practice Address - City:MADISON HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48071-1119
Practice Address - Country:US
Practice Address - Phone:866-876-2747
Practice Address - Fax:586-620-6040
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-19
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist