Provider Demographics
NPI:1407009434
Name:KEELEY, DONNA ANGELINI (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:ANGELINI
Last Name:KEELEY
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:MISS
Other - First Name:DONNA
Other - Middle Name:MARIE
Other - Last Name:ANGELINI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA/L
Mailing Address - Street 1:115 S PROVIDENCE RD
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19086-6333
Mailing Address - Country:US
Mailing Address - Phone:610-565-3232
Mailing Address - Fax:
Practice Address - Street 1:115 S PROVIDENCE RD
Practice Address - Street 2:
Practice Address - City:WALLINGFORD
Practice Address - State:PA
Practice Address - Zip Code:19086-6333
Practice Address - Country:US
Practice Address - Phone:610-565-3232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-04
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP002185L224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant