Provider Demographics
NPI:1215553763
Name:DONNELLY, ANN JACQUELYN (MS OTR/L)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:JACQUELYN
Last Name:DONNELLY
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 FOX TRL
Mailing Address - Street 2:
Mailing Address - City:PARKESBURG
Mailing Address - State:PA
Mailing Address - Zip Code:19365-2170
Mailing Address - Country:US
Mailing Address - Phone:610-513-4363
Mailing Address - Fax:
Practice Address - Street 1:2004 OLD ARCH RD
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19401-2008
Practice Address - Country:US
Practice Address - Phone:610-277-0380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-21
Last Update Date:2020-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC016532225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist