Provider Demographics
NPI:1306608369
Name:RICHARDSON, DONNA G
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:G
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 WHITMAR DR
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70401-1084
Mailing Address - Country:US
Mailing Address - Phone:985-981-2010
Mailing Address - Fax:
Practice Address - Street 1:45050 RIVER RD
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70401-4220
Practice Address - Country:US
Practice Address - Phone:985-345-8481
Practice Address - Fax:985-474-8689
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA55002355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant