Provider Demographics
NPI:1063028785
Name:DONATTO, LYNNEL (M ED)
Entity Type:Individual
Prefix:
First Name:LYNNEL
Middle Name:
Last Name:DONATTO
Suffix:
Gender:F
Credentials:M ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3183 VAN AKEN BLVD
Mailing Address - Street 2:
Mailing Address - City:SHAKER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44120-2818
Mailing Address - Country:US
Mailing Address - Phone:216-272-7884
Mailing Address - Fax:
Practice Address - Street 1:3183 VAN AKEN BLVD
Practice Address - Street 2:
Practice Address - City:SHAKER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44120-2818
Practice Address - Country:US
Practice Address - Phone:216-272-7884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-17
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
376J00000X
OH1831497376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker