Provider Demographics
NPI:1881639086
Name:NOTHDURFT, DONNA JEAN (MS, OTR, CHT)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:JEAN
Last Name:NOTHDURFT
Suffix:
Gender:F
Credentials:MS, OTR, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 E LAKE DR
Mailing Address - Street 2:
Mailing Address - City:TARPON SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34688-8108
Mailing Address - Country:US
Mailing Address - Phone:727-945-1867
Mailing Address - Fax:
Practice Address - Street 1:3488 E LAKE RD
Practice Address - Street 2:SUITE 302
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34685-2404
Practice Address - Country:US
Practice Address - Phone:727-786-1996
Practice Address - Fax:727-789-2111
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT4842225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist