Provider Demographics
NPI:1124313473
Name:MCDONALD, DENISE MARIE (MS)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:MARIE
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 LOCH LOMOND RD
Mailing Address - Street 2:APARTMENT E
Mailing Address - City:PHILIPSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16866-1954
Mailing Address - Country:US
Mailing Address - Phone:814-343-4643
Mailing Address - Fax:
Practice Address - Street 1:550 WEST COLLEGE AVENUE
Practice Address - Street 2:
Practice Address - City:PLEASANT GAP
Practice Address - State:PA
Practice Address - Zip Code:16823
Practice Address - Country:US
Practice Address - Phone:717-242-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-15
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL002545L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist