Provider Demographics
NPI:1477873800
Name:DONAHUE, HEATHER L
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:L
Last Name:DONAHUE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 W PENN AVE
Mailing Address - Street 2:
Mailing Address - City:ROBESONIA
Mailing Address - State:PA
Mailing Address - Zip Code:19551-1504
Mailing Address - Country:US
Mailing Address - Phone:610-693-6184
Mailing Address - Fax:
Practice Address - Street 1:336 WEST END AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603
Practice Address - Country:US
Practice Address - Phone:717-393-8451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-08
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATOP008163224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant