Provider Demographics
NPI:1043443484
Name:ARNETT, DONNA J (MSCCCC)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:J
Last Name:ARNETT
Suffix:
Gender:F
Credentials:MSCCCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 BAY TRACE DR
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32459-5688
Mailing Address - Country:US
Mailing Address - Phone:850-332-0161
Mailing Address - Fax:
Practice Address - Street 1:6012 MAGNOLIA BEACH RD
Practice Address - Street 2:SUITE 605
Practice Address - City:PANAMA CITY BEACH
Practice Address - State:FL
Practice Address - Zip Code:32408-7065
Practice Address - Country:US
Practice Address - Phone:850-230-1802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-02
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA651235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist