Provider Demographics
NPI:1053992842
Name:STEVENS, DONNA SHULER (CCC-SLP, MSP)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:SHULER
Last Name:STEVENS
Suffix:
Gender:F
Credentials:CCC-SLP, MSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:196 BEECHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PAULINE
Mailing Address - State:SC
Mailing Address - Zip Code:29374-2530
Mailing Address - Country:US
Mailing Address - Phone:864-590-3489
Mailing Address - Fax:
Practice Address - Street 1:196 BEECHWOOD DR
Practice Address - Street 2:
Practice Address - City:PAULINE
Practice Address - State:SC
Practice Address - Zip Code:29374-2530
Practice Address - Country:US
Practice Address - Phone:864-590-3489
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-14
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC627235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist