Provider Demographics
NPI:1477868149
Name:SANDER, DONNA JO (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:JO
Last Name:SANDER
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 ACADEMY STREET
Mailing Address - Street 2:THE AROOSTOOK MEDICAL CENTER, OCCUPATIONAL THERAPY
Mailing Address - City:PRESQUE ISLE
Mailing Address - State:ME
Mailing Address - Zip Code:04769-5247
Mailing Address - Country:US
Mailing Address - Phone:207-768-4169
Mailing Address - Fax:
Practice Address - Street 1:140 ACADEMY STREET
Practice Address - Street 2:THE AROOSTOOK MEDICAL CENTER, OCCUPATIONAL THERAPY
Practice Address - City:PRESQUE ISLE
Practice Address - State:ME
Practice Address - Zip Code:04769-5247
Practice Address - Country:US
Practice Address - Phone:207-768-4169
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-18
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT507225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics