Most Relevant Information
Provider Data
| NPI Number: | 1003554668 |
| Provider Name: | MARK MICHAEL DONNELLY |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/24/2022 |
| Last Updated: | 05/24/2022 |
Provider Practice Location
9361 S 300 E
SANDY
UT
840702902
Practice Location Phone/Fax
| Phone: | 8018265000 |
| Fax: |
Provider Mailing Location
2287 E HIGH MOUNTAIN DR
SANDY
UT
840925506
Provider Mailing Phone/Fax
| Phone: | 8017060459 |
| Fax: |