Provider Demographics
NPI:1851532618
Name:NUCUM, MARIA DONNA MAE LEGASPI
Entity Type:Individual
Prefix:
First Name:MARIA DONNA MAE
Middle Name:LEGASPI
Last Name:NUCUM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARIA DONNA MAE
Other - Middle Name:ROPETA
Other - Last Name:LEGASPI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1017 SHERIDAN CIR
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-4214
Mailing Address - Country:US
Mailing Address - Phone:630-888-0926
Mailing Address - Fax:
Practice Address - Street 1:1017 SHERIDAN CIR
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-4214
Practice Address - Country:US
Practice Address - Phone:630-888-0926
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-09
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist