Provider Demographics
NPI:1568174894
Name:DONALDSON, DINA EILEEN
Entity Type:Individual
Prefix:
First Name:DINA
Middle Name:EILEEN
Last Name:DONALDSON
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 1:1136 BONNIEBROOK RD
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16002-0012
Mailing Address - Country:US
Mailing Address - Phone:724-504-8994
Mailing Address - Fax:
Practice Address - Street 1:30 GLADE RUN DR
Practice Address - Street 2:
Practice Address - City:ZELIENOPLE
Practice Address - State:PA
Practice Address - Zip Code:16063-2200
Practice Address - Country:US
Practice Address - Phone:724-452-4453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
00000000000OtherNO OTHER ISSUER