Provider Demographics
NPI:1386981082
Name:CLEMENT, DONNA MARIE
Entity type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:MARIE
Last Name:CLEMENT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9821
Mailing Address - Street 2:COTTO STATION
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00613-9821
Mailing Address - Country:US
Mailing Address - Phone:787-454-7145
Mailing Address - Fax:
Practice Address - Street 1:272 EDIFICIO TROPICAL PLAZA
Practice Address - Street 2:CARRETERA #2 MARGINAL
Practice Address - City:HATILLO
Practice Address - State:PR
Practice Address - Zip Code:00659
Practice Address - Country:US
Practice Address - Phone:787-454-7145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-15
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist