Provider Demographics
NPI:1457667438
Name:JAMES A. DONNER, PSY.D, P.A.
Entity Type:Organization
Organization Name:JAMES A. DONNER, PSY.D, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:DONNER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:850-586-7762
Mailing Address - Street 1:11 RACETRACK RD NE
Mailing Address - Street 2:SUITE D2
Mailing Address - City:FORT WALTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32547-1882
Mailing Address - Country:US
Mailing Address - Phone:850-586-7762
Mailing Address - Fax:850-586-7763
Practice Address - Street 1:11 RACETRACK RD NE
Practice Address - Street 2:SUITE D2
Practice Address - City:FORT WALTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:32547-1882
Practice Address - Country:US
Practice Address - Phone:850-586-7762
Practice Address - Fax:850-586-7763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-27
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7250103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty