Provider Demographics
NPI:1922217876
Name:GREENLEE, DONNA L (OTR)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:L
Last Name:GREENLEE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MS
Other - First Name:DONNA
Other - Middle Name:L
Other - Last Name:BOLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:249 OLIVER EDWARDS RD
Mailing Address - Street 2:
Mailing Address - City:JONESBOROUGH
Mailing Address - State:TN
Mailing Address - Zip Code:37659-6537
Mailing Address - Country:US
Mailing Address - Phone:423-823-1323
Mailing Address - Fax:423-235-6863
Practice Address - Street 1:249 OLIVER EDWARDS RD
Practice Address - Street 2:
Practice Address - City:JONESBOROUGH
Practice Address - State:TN
Practice Address - Zip Code:37659-6537
Practice Address - Country:US
Practice Address - Phone:423-823-1323
Practice Address - Fax:423-235-6863
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNOT1459225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist