Provider Demographics
NPI:1487531356
Name:DONAHUE, GRACE MAE (OTD, OTR/L)
Entity type:Individual
Prefix:DR
First Name:GRACE
Middle Name:MAE
Last Name:DONAHUE
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4159 RESERVE RD APT 306
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40514-4076
Mailing Address - Country:US
Mailing Address - Phone:704-421-3130
Mailing Address - Fax:
Practice Address - Street 1:4159 RESERVE RD APT 306
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40514-4076
Practice Address - Country:US
Practice Address - Phone:704-421-3130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-20
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY301847225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist