Provider Demographics
NPI:1285189209
Name:CARTER, DONNA MARIE (OCCUPATIONAL THERAPI)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:MARIE
Last Name:CARTER
Suffix:
Gender:F
Credentials:OCCUPATIONAL THERAPI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11202 CAPTAINS COVE DR
Mailing Address - Street 2:
Mailing Address - City:SODDY DAISY
Mailing Address - State:TN
Mailing Address - Zip Code:37379-5767
Mailing Address - Country:US
Mailing Address - Phone:423-364-7010
Mailing Address - Fax:
Practice Address - Street 1:11202 CAPTAINS COVE DR
Practice Address - Street 2:
Practice Address - City:SODDY DAISY
Practice Address - State:TN
Practice Address - Zip Code:37379-5767
Practice Address - Country:US
Practice Address - Phone:423-364-7010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-19
Last Update Date:2016-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNOT0000003650261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation