Provider Demographics
NPI:1578754339
Name:ERIBES, DONNA M (OTR/L)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:M
Last Name:ERIBES
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14006 E CEDAR WAXWING DR
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85249-9229
Mailing Address - Country:US
Mailing Address - Phone:480-897-6233
Mailing Address - Fax:
Practice Address - Street 1:14006 E CEDAR WAXWING DR
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85249-9229
Practice Address - Country:US
Practice Address - Phone:480-897-6233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2633174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist