Provider Demographics
NPI:1265776736
Name:DONISI, ANTHONY THONPSON (PCC-S, MA, MS)
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:THONPSON
Last Name:DONISI
Suffix:
Gender:M
Credentials:PCC-S, MA, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3610 DITMER RD
Mailing Address - Street 2:
Mailing Address - City:LAURA
Mailing Address - State:OH
Mailing Address - Zip Code:45337-8742
Mailing Address - Country:US
Mailing Address - Phone:513-267-9340
Mailing Address - Fax:
Practice Address - Street 1:3610 DITMER RD
Practice Address - Street 2:
Practice Address - City:LAURA
Practice Address - State:OH
Practice Address - Zip Code:45337-8742
Practice Address - Country:US
Practice Address - Phone:513-267-9340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-21
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE617 SUPV101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional