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General NPI Number Information
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NPI Number | 1215665765
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Entity Type | Individual
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Provider Name | EMILEE DONOVAN
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Gender | Female
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Dates
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Enumeration Date | 08/11/2022
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Last Update Date | 02/27/2025
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Provider Practice Location Address
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Address Line | 1301 KIOWA ST
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City | ARDMORE
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State | OK
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Zip | 73401-2280
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Country | US
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Telephone | 580-670-3117
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Fax | 580-768-0767
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Provider Business Mailing Address
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Address Line | 700 ROSEWOOD ST
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City | ARDMORE
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State | OK
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Zip | 73401-3025
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Country | US
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Telephone | 580-319-6612
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State |
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