| Doctor Name: | DONNA BENNETT |
| NPI Number: | 1689728222 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | SLPS4106 |
| Business Practice Address: | 1760 Joy Ln Fort Mohave, AZ - 864269294 |
| Business Phone Number: | 9287683986 |
| Business Fax Number: | 9287688075 |
| Mailing Address: | Po Box 5070, MOHAVE VALLEY |
| State: | AZ |
| Postal Code: | 864465070 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 01/22/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SLPS4106 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |