Healthcare Provider Details

I. General information

NPI: 1902007388
Provider Name (Legal Business Name): SHELBY RHEA DONAHOO MS OTRL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7540 NORTH 19TH AVE
PHOENIX AZ
85021
US

IV. Provider business mailing address

11005 N INDIAN WELLS DR
FOUNTAIN HILLS AZ
85268
US

V. Phone/Fax

Practice location:
  • Phone: 602-324-6505
  • Fax: 888-543-2289
Mailing address:
  • Phone: 480-393-0434
  • Fax: 480-634-7756

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number3084
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: