Provider Demographics
NPI:1518238146
Name:DONATO, PAULETTE
Entity Type:Individual
Prefix:MS
First Name:PAULETTE
Middle Name:
Last Name:DONATO
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 1:4031 N BENNINGTON AVE APT 103
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64117-2992
Mailing Address - Country:US
Mailing Address - Phone:816-326-7527
Mailing Address - Fax:
Practice Address - Street 1:1200 W COLLEGE ST
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:MO
Practice Address - Zip Code:64068-1036
Practice Address - Country:US
Practice Address - Phone:816-781-3020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-12
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO004943224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant