Individual
JEANETTE DONALDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5200 BABCOCK ST NE STE 400, PALM BAY, FL 32905-4612
(321) 984-9606
Mailing address
106 PELICAN DR, MELBOURNE BEACH, FL 32951-3735
(321) 723-1627
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6116
LICENSE #
FL
Enumeration date
09/20/2006
Last updated
07/08/2007
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