Provider Demographics
NPI:1508401605
Name:HARRELL, DONNA N
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:N
Last Name:HARRELL
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 1:27707 JUANITA DR
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:AL
Mailing Address - Zip Code:35613-6947
Mailing Address - Country:US
Mailing Address - Phone:915-433-9659
Mailing Address - Fax:
Practice Address - Street 1:27707 JUANITA DR
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:AL
Practice Address - Zip Code:35613-6947
Practice Address - Country:US
Practice Address - Phone:915-433-9659
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-12
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services