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General NPI Number Information
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NPI Number | 1508191925
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Entity Type | Individual
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Provider Name | DONNA BOULANGER MS, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 10/04/2009
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Last Update Date | 10/04/2009
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Provider Practice Location Address
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Address Line | 1 HEIDELBERG DR
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City | WERNERSVILLE
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State | PA
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Zip | 19565-1642
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Country | US
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Telephone | 610-927-8560
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Fax |
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Provider Business Mailing Address
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Address Line | 2812 KINGSTON DR
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City | SINKING SPRING
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State | PA
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Zip | 19608-1677
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Country | US
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Telephone | 610-564-5587
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OC004304L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 225XL0004X
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Taxonomy Name | Low Vision Occupational Therapist
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License Number | OC004304L
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License Number State | PA
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