Provider Demographics
NPI:1164461232
Name:GILMAN, DONNA MICHELLE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:MICHELLE
Last Name:GILMAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:182 MAIN ST STE 202
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-3143
Mailing Address - Country:US
Mailing Address - Phone:413-687-7681
Mailing Address - Fax:
Practice Address - Street 1:182 MAIN ST STE 202
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3143
Practice Address - Country:US
Practice Address - Phone:413-687-7681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-05
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8490103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical