Provider Demographics
NPI:1528220738
Name:GARRETT, DONNA LYNNE (OTRL)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:LYNNE
Last Name:GARRETT
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 STRATFORD WOODS RD
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-2611
Mailing Address - Country:US
Mailing Address - Phone:704-321-0959
Mailing Address - Fax:
Practice Address - Street 1:3315 FAITH CHURCH RD
Practice Address - Street 2:
Practice Address - City:INDIAN TRAIL
Practice Address - State:NC
Practice Address - Zip Code:28079-9300
Practice Address - Country:US
Practice Address - Phone:704-882-3420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-29
Last Update Date:2008-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3771225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist