Provider Demographics
NPI:1437924743
Name:DONADIO, MARJORIE QUILIZA (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:MARJORIE
Middle Name:QUILIZA
Last Name:DONADIO
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2908 CARRIAGE MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-7052
Mailing Address - Country:US
Mailing Address - Phone:919-909-8875
Mailing Address - Fax:
Practice Address - Street 1:1704 NC 39 HWY N
Practice Address - Street 2:
Practice Address - City:LOUISBURG
Practice Address - State:NC
Practice Address - Zip Code:27549-8329
Practice Address - Country:US
Practice Address - Phone:919-496-7222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-16
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16238224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant