Provider Demographics
NPI:1851757330
Name:HARBAUGH, DONNA ANITA (LMT)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:ANITA
Last Name:HARBAUGH
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 E. FRONT ST
Mailing Address - Street 2:SUITE 509
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701
Mailing Address - Country:US
Mailing Address - Phone:406-548-1506
Mailing Address - Fax:
Practice Address - Street 1:501 E. FRONT ST
Practice Address - Street 2:SUITE 509
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701
Practice Address - Country:US
Practice Address - Phone:406-548-1506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-13
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT85225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist