Provider Demographics
NPI:1104236892
Name:ANTHONY, DONNA (MED)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:ANTHONY
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:ANTHONY
Other - Last Name:OLSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:36 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:RI
Mailing Address - Zip Code:02806-4716
Mailing Address - Country:US
Mailing Address - Phone:401-580-9588
Mailing Address - Fax:
Practice Address - Street 1:1 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-3960
Practice Address - Country:US
Practice Address - Phone:508-828-9116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-02
Last Update Date:2014-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health