Provider Demographics
NPI:1689219164
Name:DONAGHE, MELISSA LYNN (PTA)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:LYNN
Last Name:DONAGHE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:LYNN
Other - Last Name:WASCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:419 STEAM PLANT RD
Mailing Address - Street 2:
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-3027
Mailing Address - Country:US
Mailing Address - Phone:615-230-4600
Mailing Address - Fax:
Practice Address - Street 1:419 STEAM PLANT RD
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-3027
Practice Address - Country:US
Practice Address - Phone:615-230-4600
Practice Address - Fax:615-230-4602
Is Sole Proprietor?:No
Enumeration Date:2019-11-08
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5502004087225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant