Provider Demographics
NPI:1003679945
Name:DONALDSON, JILL (OTR/L)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:DONALDSON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 IVY CREEK LN UNIT 402
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-5135
Mailing Address - Country:US
Mailing Address - Phone:919-280-3035
Mailing Address - Fax:
Practice Address - Street 1:305 GRISTMILL DR
Practice Address - Street 2:
Practice Address - City:FOREST
Practice Address - State:VA
Practice Address - Zip Code:24551-2627
Practice Address - Country:US
Practice Address - Phone:434-385-1074
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-02
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119010299225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics