Healthcare Provider Details

I. General information

NPI: 1972724615
Provider Name (Legal Business Name): DONNA ROWAN CULLEY M.A. CCC/SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 07/05/2023
Certification Date: 07/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6960 S EDGERTON RD
BRECKSVILLE OH
44141-3184
US

IV. Provider business mailing address

6960 S EDGERTON RD
BRECKSVILLE OH
44141-3184
US

V. Phone/Fax

Practice location:
  • Phone: 440-241-8366
  • Fax: 440-723-2333
Mailing address:
  • Phone: 440-241-8366
  • Fax: 440-723-2333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP 8716
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: