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General NPI Number Information
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NPI Number | 1003109778
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Entity Type | Individual
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Provider Name | BRENT DONOHOE BC-HIS
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Gender | Male
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Dates
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Enumeration Date | 05/27/2011
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Last Update Date | 05/27/2011
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Provider Practice Location Address
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Address Line | 6231 LEESBURG PIKE STE 510
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City | FALLS CHURCH
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State | VA
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Zip | 22044-2102
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Country | US
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Telephone | 703-533-1622
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Fax | 703-533-0920
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Provider Business Mailing Address
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Address Line | 6231 LEESBURG PIKE STE 510
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City | FALLS CHURCH
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State | VA
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Zip | 22044-2102
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Country | US
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Telephone | 703-533-1622
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Fax | 703-533-0920
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2355A2700X
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Taxonomy Name | Audiology Assistant
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License Number | 2101001616
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | 2101001616
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License Number State | VA
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