Provider Demographics
NPI:1639724446
Name:PRICE-DONELSON, SHONDALYNN DENISE
Entity type:Individual
Prefix:
First Name:SHONDALYNN
Middle Name:DENISE
Last Name:PRICE-DONELSON
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 1:44 OTTAWA LANDINGS DR APT 203
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43607-2431
Mailing Address - Country:US
Mailing Address - Phone:419-283-2110
Mailing Address - Fax:
Practice Address - Street 1:44 OTTAWA LANDINGS DR APT 203
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43607-2431
Practice Address - Country:US
Practice Address - Phone:419-283-2110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-08
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0363545Medicaid