Provider Demographics
NPI:1366473944
Name:DEVITTE, DONNA WHITE (MPT)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:WHITE
Last Name:DEVITTE
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:J
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:61 HIGHLAND DRIVE
Mailing Address - Street 2:
Mailing Address - City:HENNIKER
Mailing Address - State:NH
Mailing Address - Zip Code:03242
Mailing Address - Country:US
Mailing Address - Phone:603-491-1998
Mailing Address - Fax:
Practice Address - Street 1:171 PLEASANT STREET
Practice Address - Street 2:STE 101
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301
Practice Address - Country:US
Practice Address - Phone:603-228-7500
Practice Address - Fax:603-228-3503
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2726225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30393244Medicaid
NH1822292OtherCAQH PROVIDER ID
NH30393244Medicaid