Provider Demographics
NPI:1740794841
Name:DONNES, AMBER MAXWELL (MOT)
Entity type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:MAXWELL
Last Name:DONNES
Suffix:
Gender:F
Credentials:MOT
Other - Prefix:MS
Other - First Name:AMBER
Other - Middle Name:LAINE
Other - Last Name:MAXWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MOT
Mailing Address - Street 1:9249 BAKER DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-2341
Mailing Address - Country:US
Mailing Address - Phone:318-470-4498
Mailing Address - Fax:
Practice Address - Street 1:6723 JEFFERSON HWY
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-8106
Practice Address - Country:US
Practice Address - Phone:225-926-2400
Practice Address - Fax:225-926-2400
Is Sole Proprietor?:No
Enumeration Date:2017-11-28
Last Update Date:2017-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAOTT.200272225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation