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Individual

MS. MARY ELLEN DONOVAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
110 CHERRY ST, HOLYOKE, MA 01040-7002
(413) 539-6910
Mailing address
15 PARKER AVE, WESTFIELD, MA 01085
(413) 218-8589

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
3590
CT
225X00000X
Occupational Therapist
Primary
9943
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
9943
OCCUPATIONAL THERAPIST
MA
Enumeration date
11/05/2009
Last updated
11/05/2009
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