Provider Demographics
NPI:1912386442
Name:STEGALL, DONNA (OTR/L)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:STEGALL
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4258 HIGHWAY 49 S UNIT 554
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28075-0137
Mailing Address - Country:US
Mailing Address - Phone:704-559-9409
Mailing Address - Fax:704-731-0975
Practice Address - Street 1:4350 MAIN ST STE 217
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:NC
Practice Address - Zip Code:28075-7448
Practice Address - Country:US
Practice Address - Phone:704-559-9409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-29
Last Update Date:2015-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9684225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist