Provider Demographics
NPI:1114993870
Name:NOONAN, DONNA J (OTR/L)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:J
Last Name:NOONAN
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 1:300 TOWER HILL RD
Mailing Address - Street 2:
Mailing Address - City:NORTH KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02852-4814
Mailing Address - Country:US
Mailing Address - Phone:401-295-8500
Mailing Address - Fax:401-295-8536
Practice Address - Street 1:300 TOWER HILL RD
Practice Address - Street 2:
Practice Address - City:NORTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02852-4814
Practice Address - Country:US
Practice Address - Phone:401-295-8500
Practice Address - Fax:401-295-8536
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI60225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI402265OtherBLUECHIP
RI0070023231Medicare ID - Type Unspecified