Provider Demographics
NPI:1346451580
Name:DONAHUE, LAURIE A (MS ATC)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:A
Last Name:DONAHUE
Suffix:
Gender:F
Credentials:MS ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53032 SCENIC DR
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48316-2149
Mailing Address - Country:US
Mailing Address - Phone:248-650-0391
Mailing Address - Fax:
Practice Address - Street 1:48875 HAYES RD
Practice Address - Street 2:
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48315-4405
Practice Address - Country:US
Practice Address - Phone:586-532-9602
Practice Address - Fax:586-532-9005
Is Sole Proprietor?:No
Enumeration Date:2007-05-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer