Provider Demographics
NPI:1104883545
Name:DONLEY, AMY M (SLP)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:M
Last Name:DONLEY
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 858
Mailing Address - Street 2:
Mailing Address - City:HOLDREGE
Mailing Address - State:NE
Mailing Address - Zip Code:68949-0858
Mailing Address - Country:US
Mailing Address - Phone:308-995-6585
Mailing Address - Fax:308-995-6587
Practice Address - Street 1:515 JEWELL ST
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:NE
Practice Address - Zip Code:68920-2067
Practice Address - Country:US
Practice Address - Phone:308-928-2131
Practice Address - Fax:308-928-2763
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1147235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47065477700Medicaid