Basic Information
Provider Information
NPI: 1871732743
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DONEY
FirstName: JENNIFER
MiddleName:  
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Credential: PTA
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Mailing Information
Address1: 20410 CENTURY BLVD
Address2: NRH REGIONAL REHAB - SUITE 215
City: GERMANTOWN
State: MD
PostalCode: 208741186
CountryCode: US
TelephoneNumber: 3015406140
FaxNumber:  
Practice Location
Address1: 24035 THREE NOTCH RD
Address2:  
City: HOLLYWOOD
State: MD
PostalCode: 206364871
CountryCode: US
TelephoneNumber: 3015406140
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/17/2009
LastUpdateDate: 02/17/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225200000XA3377MDY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant 

No ID Information.


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