Individual
MRS. IRENE T DONALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
29620 BAYSHORE DR N, ORANGE BEACH, AL 36561-4201
(251) 610-8063
Mailing address
29620 BAYSHORE DR N, ORANGE BEACH, AL 36561-4201
(251) 610-8063
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MBG822283548
SELF
AL
Enumeration date
08/27/2019
Last updated
08/27/2019
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