Individual
MS. DONNA JO HAIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
930 S BAXTER AVE, TYLER, TX 75701-2209
(903) 595-4668
Mailing address
930 S BAXTER AVE, TYLER, TX 75701-2209
(903) 595-4668
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
210973
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001025984
—
TX
Enumeration date
12/30/2014
Last updated
12/30/2014
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