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Individual

MELISSA DONAHUE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA

Contact information

Practice address
602 VONDERBURG DR, SUITE 200, BRANDON, FL 33511-5900
(813) 653-1149
Mailing address
8211 LAGERFELD DR, LAND O LAKES, FL 34637-3207

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA10985
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
OTA10985
DOH LICENSE
FL
Enumeration date
11/23/2012
Last updated
11/23/2012
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