Provider Demographics
NPI:1912209479
Name:JENKINS, DONNA M (OT)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:M
Last Name:JENKINS
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 388
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:NH
Mailing Address - Zip Code:03743-0388
Mailing Address - Country:US
Mailing Address - Phone:802-674-4655
Mailing Address - Fax:
Practice Address - Street 1:54 MAIN ST # LL2
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:VT
Practice Address - Zip Code:05089-1321
Practice Address - Country:US
Practice Address - Phone:802-674-4655
Practice Address - Fax:802-674-4656
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-03
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1042225X00000X
VT072 0000486225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist