Provider Demographics
NPI:1407027253
Name:COLLETTA, NANCY DONOHUE (PHD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:DONOHUE
Last Name:COLLETTA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5225 CONNECTICUT AVE NW
Mailing Address - Street 2:313
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20015-1813
Mailing Address - Country:US
Mailing Address - Phone:202-244-3919
Mailing Address - Fax:202-244-3919
Practice Address - Street 1:5225 CONNECTICUT AVE NW
Practice Address - Street 2:313
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20015-1813
Practice Address - Country:US
Practice Address - Phone:202-244-3919
Practice Address - Fax:202-244-3919
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-20
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPSY1478174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist