Provider Demographics
NPI:1104105659
Name:DONELAN, BRIE (MS, CFY-SLP)
Entity type:Individual
Prefix:MS
First Name:BRIE
Middle Name:
Last Name:DONELAN
Suffix:
Gender:F
Credentials:MS, CFY-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3004 S 28TH PL
Mailing Address - Street 2:APT. 4
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-4993
Mailing Address - Country:US
Mailing Address - Phone:845-222-1107
Mailing Address - Fax:
Practice Address - Street 1:500 SE 18TH ST
Practice Address - Street 2:RUTH BARKER MIDDLE SCHOOL
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-7917
Practice Address - Country:US
Practice Address - Phone:479-696-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-15
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist