Healthcare Provider Details

I. General information

NPI: 1376843946
Provider Name (Legal Business Name): DONNA KOLLAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2010
Last Update Date: 10/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8747 SQUIRES LN NE
WARREN OH
44484-1649
US

IV. Provider business mailing address

PO BOX 1113
YOUNGSTOWN OH
44501-1113
US

V. Phone/Fax

Practice location:
  • Phone: 330-841-3776
  • Fax:
Mailing address:
  • Phone: 330-884-4571
  • Fax: 330-884-0175

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: