Provider Demographics
NPI:1437993102
Name:DONALD, LUCILE ADELINE (AUD)
Entity type:Individual
Prefix:DR
First Name:LUCILE
Middle Name:ADELINE
Last Name:DONALD
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:LUCILE
Other - Middle Name:ADELINE
Other - Last Name:PURANEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1405 CENTERVILLE RD STE 5400
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-4654
Mailing Address - Country:US
Mailing Address - Phone:850-877-0101
Mailing Address - Fax:
Practice Address - Street 1:1405 CENTERVILLE RD STE 5400
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4654
Practice Address - Country:US
Practice Address - Phone:850-877-0101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-19
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY2814231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist