Provider Demographics
NPI:1548541295
Name:DONALD, TONYA LADAWN (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:TONYA
Middle Name:LADAWN
Last Name:DONALD
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 INDUSTRIAL CV
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39157-2715
Mailing Address - Country:US
Mailing Address - Phone:601-607-7820
Mailing Address - Fax:601-607-7822
Practice Address - Street 1:205 INDUSTRIAL CV
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-2715
Practice Address - Country:US
Practice Address - Phone:601-607-7820
Practice Address - Fax:601-607-7822
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-07
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSOT199225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist