Provider Demographics
NPI:1083349286
Name:DONAHUE, LINDSEY KELLY (ATC/L)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:KELLY
Last Name:DONAHUE
Suffix:
Gender:
Credentials:ATC/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 BULLARD AVE
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-1602
Mailing Address - Country:US
Mailing Address - Phone:781-572-6566
Mailing Address - Fax:
Practice Address - Street 1:75 CYPRESS AVE
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:MA
Practice Address - Zip Code:01545-1312
Practice Address - Country:US
Practice Address - Phone:508-841-8835
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-21
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA26892255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Single Specialty