Provider Demographics
NPI:1154435956
Name:DONALDSON, JOY JENNIFER (OTRL)
Entity type:Individual
Prefix:MRS
First Name:JOY
Middle Name:JENNIFER
Last Name:DONALDSON
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:MS
Other - First Name:JOY
Other - Middle Name:JENNIFER
Other - Last Name:FORSTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTRL
Mailing Address - Street 1:3154 LINCOLN ST NE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55418
Mailing Address - Country:US
Mailing Address - Phone:612-788-9074
Mailing Address - Fax:
Practice Address - Street 1:1800 NE 2ND ST
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55418
Practice Address - Country:US
Practice Address - Phone:612-706-5553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN102076225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist