Provider Demographics
NPI:1568911493
Name:VICKNAIR, DONNA MARIE (MOT, CHT)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:MARIE
Last Name:VICKNAIR
Suffix:
Gender:F
Credentials:MOT, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2831 RINGLING BLVD STE E120
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34237-5353
Mailing Address - Country:US
Mailing Address - Phone:941-955-2020
Mailing Address - Fax:941-955-2120
Practice Address - Street 1:2831 RINGLING BLVD STE E120
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34237-5353
Practice Address - Country:US
Practice Address - Phone:941-955-2020
Practice Address - Fax:941-955-2120
Is Sole Proprietor?:No
Enumeration Date:2016-10-04
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL17757225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand