Provider Demographics
NPI:1205304920
Name:GROVES, DONNA (OTR)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:GROVES
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:739 LCR 890
Mailing Address - Street 2:
Mailing Address - City:JEWETT
Mailing Address - State:TX
Mailing Address - Zip Code:75846-5661
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:501 E SUMPTER ST
Practice Address - Street 2:
Practice Address - City:MEXIA
Practice Address - State:TX
Practice Address - Zip Code:76667-2354
Practice Address - Country:US
Practice Address - Phone:254-472-0630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-12
Last Update Date:2018-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX104252225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist