Provider Demographics
NPI:1609934405
Name:CLIFTON, DONNA MARIE (COTA)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:MARIE
Last Name:CLIFTON
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238 LAURENS LN
Mailing Address - Street 2:
Mailing Address - City:GRIMSLEY
Mailing Address - State:TN
Mailing Address - Zip Code:38565-6003
Mailing Address - Country:US
Mailing Address - Phone:931-863-5763
Mailing Address - Fax:
Practice Address - Street 1:REHAB AMERICA
Practice Address - Street 2:444 ONE ELEVEN PLACE
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38506
Practice Address - Country:US
Practice Address - Phone:931-526-6655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNOTA1429224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant