Provider Demographics
NPI:1629426341
Name:SANDERS, DONNA WILSON (OT/L,)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:WILSON
Last Name:SANDERS
Suffix:
Gender:F
Credentials:OT/L,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 OLD BALSAM ROAD
Mailing Address - Street 2:AUTUMN CARE NURSING AND REHABILITATION CENTER
Mailing Address - City:WAYNESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28786
Mailing Address - Country:US
Mailing Address - Phone:828-452-1935
Mailing Address - Fax:
Practice Address - Street 1:360 OLD BALSAM RD
Practice Address - Street 2:360 OLD BALSAM ROAD
Practice Address - City:WAYNESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28786-8097
Practice Address - Country:US
Practice Address - Phone:828-452-1935
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-03
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2077225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist