Provider Demographics
NPI:1346698107
Name:DOHENY, DEANNA (ATC, NREMT)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:
Last Name:DOHENY
Suffix:
Gender:F
Credentials:ATC, NREMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 BERKELEY AVE
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-1804
Mailing Address - Country:US
Mailing Address - Phone:201-803-0958
Mailing Address - Fax:
Practice Address - Street 1:6100 MAIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77005-1827
Practice Address - Country:US
Practice Address - Phone:201-803-0958
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-01
Last Update Date:2020-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX759866146N00000X
174H00000X
TXAT79092255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic
No174H00000XOther Service ProvidersHealth Educator