Provider Demographics
NPI:1215665765
Name:DONOVAN, EMILEE
Entity type:Individual
Prefix:
First Name:EMILEE
Middle Name:
Last Name:DONOVAN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 ROSEWOOD ST
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:OK
Mailing Address - Zip Code:73401-3025
Mailing Address - Country:US
Mailing Address - Phone:580-319-6612
Mailing Address - Fax:
Practice Address - Street 1:1301 KIOWA ST
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-2280
Practice Address - Country:US
Practice Address - Phone:580-670-3117
Practice Address - Fax:580-768-0767
Is Sole Proprietor?:No
Enumeration Date:2022-08-11
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics