Provider Demographics
NPI:1225280076
Name:DONOVAN, LESLIE ANN (MOTR/L)
Entity Type:Individual
Prefix:MISS
First Name:LESLIE
Middle Name:ANN
Last Name:DONOVAN
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:780 WHEATLAND CIR
Mailing Address - Street 2:
Mailing Address - City:BRIDGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15017-1121
Mailing Address - Country:US
Mailing Address - Phone:412-914-0280
Mailing Address - Fax:
Practice Address - Street 1:1848 GREENTREE RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15220-1851
Practice Address - Country:US
Practice Address - Phone:412-344-7782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-10
Last Update Date:2008-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC008934225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist