Provider Demographics
NPI:1902091762
Name:DONADIEU, KATIE
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:DONADIEU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8080 BLUEBONNET BLVD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810
Mailing Address - Country:US
Mailing Address - Phone:225-408-7990
Mailing Address - Fax:225-408-7989
Practice Address - Street 1:8080 BLUEBONNET BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810
Practice Address - Country:US
Practice Address - Phone:225-408-7990
Practice Address - Fax:225-408-7989
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-13
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAZ12398225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist