Provider Demographics
NPI:1255883914
Name:DONATO, TESSA
Entity type:Individual
Prefix:
First Name:TESSA
Middle Name:
Last Name:DONATO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:196 SAINT ANDREWS DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-8672
Mailing Address - Country:US
Mailing Address - Phone:507-351-8787
Mailing Address - Fax:
Practice Address - Street 1:196 SAINT ANDREWS DR
Practice Address - Street 2:SUITE 200
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-8672
Practice Address - Country:US
Practice Address - Phone:507-351-8787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-28
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter