Provider Demographics
NPI:1952645442
Name:OVERTON, DONNA CHARLENE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:CHARLENE
Last Name:OVERTON
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 1:102 GAZEBO CT
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28409-5051
Mailing Address - Country:US
Mailing Address - Phone:910-620-3138
Mailing Address - Fax:
Practice Address - Street 1:631 JUNCTION CREEK DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28412-2296
Practice Address - Country:US
Practice Address - Phone:910-442-3017
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-21
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC452225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist