Healthcare Provider Details

I. General information

NPI: 1356299507
Provider Name (Legal Business Name): DONNA M BRITTAIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2026
Last Update Date: 03/20/2026
Certification Date: 03/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

471 MAGNOLIA AVE E
SAINT PAUL MN
55130-3849
US

IV. Provider business mailing address

1607 PALACE AVE
SAINT PAUL MN
55105-2134
US

V. Phone/Fax

Practice location:
  • Phone: 651-776-5151
  • Fax:
Mailing address:
  • Phone: 651-295-6565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number101732
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: